[Induction of cervix maturation by oxytocin vs. PGF2 alpha infusion, vs. intracervical PGE2 gel in risk cases with immature cervix].

From April 1, 1978 to March 31, 1979 199 patients with a high risk pregnancy and a Bishop score of less than 7 among a total number of deliveries of 2075 needed induction of labour for medical indications. In 143 patients oxytocin infusions were given, in 56 patients PGF2 alpha infusions were given. It was shown that PGF2 alpha by infusion showed no advantages over oxytocin infusions. The duration of labour and delivery was not shortened. The foetal morbidity was not decreased. The incidence of Caesarean section remained unchanged at a high 32% and the incidence of vaginal operative delivery remained high at 50%. The incidence of post-partum acidosis in the newborn remained at around 14%. Therefore induction of labour was tried on the unripe cervix in the following 12 months with the intra-cervical application of 0.4 mg. PGE2 gel in 202 patients. The same criteria of high risk pregnancies and unripe cervices were used in the following 12 months. In contradistinction to the induction of labour with oxytocin infusion or PGF2 alpha infusion statistically very significant differences in favor of PGE2 gel were found. The foetal morbidity during labour, the duration of labour, the mode of delivery, the neonatal morbidity and the post-partum maternal condition regarding haemoglobin and pyrexia were improved. The low incidence of Caesarean section at 8% and the low incidence of post-partum acidosis in the newborn was especially noteworthy in the PGE2 gel group. Although excellence of prenatal care is essential for the improvement of obstetric results the timely termination of a high risk pregnancy is the second important step to reduce maternal and foetal morbidity. PGE2 gel intracervically improves this second step.