Double-blind comparison of intravaginal prostaglandin E2 gel and "chip" for preinduction cervical ripening

Carl Vernon Smith, William F. Rayburn, Robert E. Connor, Glen R. Fredstrom, Corinne B. Phillips

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

The intravaginal application of prostaglandin E2 for preinduction cervical ripening has proved to be advantageous in the management of patients with an unfavorable cervix. The purpose of this double-blind randomized investigation was to compare the efficacy and safety of two method of prostaglandin E2 delivery. Patients who were to have preinduction cervical ripening because of an unfavorable cervix (Bishop score ≤4) were randomly assigned to be given a single dose of prostaglandin E2 as either 2.5 mg of gel or a 3.0 mg "chip" intravaginally in a placebo-controlled manner. Sixty-nine patients received the active prostaglandin E2, 34 in the gel group and 35 in the "chip" group. The groups were similar in maternal age, race, parity, gestational age, and initial Bishop score. Both forms of prostaglandin E2 were easy to administer and helpful in priming an unfavorable cervix. The need for, duration of, and maximum dose of oxytocin were similar in both groups. Cesarean delivery because of failed induction occurred in 5 of 35 (14.3%) patients receiving a "chip" and 4 of 34 (11.8%) receiving the gel. However, patients receiving a "chip" experienced a 20% ( 7 35) incidence of hyperstimulation, compared with 2.9% ( 1 36) in those receiving the gel (p < 0.05). The only case requiring immediate cesarean delivery because of intractable uterine hyperstimulation received a "chip". We conclude that both methods were effective for cervical ripening, but the lower incidence of uterine hyperstimulation seen with the gel would suggest that it is preferable to the "chip".

Original languageEnglish (US)
Pages (from-to)845-847
Number of pages3
JournalAmerican Journal of Obstetrics and Gynecology
Volume163
Issue number3
DOIs
StatePublished - Jan 1 1990

Fingerprint

Cervical Ripening
Dinoprostone
Gels
Cervix Uteri
Incidence
Maternal Age
Oxytocin
Parity
Gestational Age
Placebos
Safety

Keywords

  • Prostaglandin E
  • cervical ripening
  • induction of labor

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Double-blind comparison of intravaginal prostaglandin E2 gel and "chip" for preinduction cervical ripening. / Smith, Carl Vernon; Rayburn, William F.; Connor, Robert E.; Fredstrom, Glen R.; Phillips, Corinne B.

In: American Journal of Obstetrics and Gynecology, Vol. 163, No. 3, 01.01.1990, p. 845-847.

Research output: Contribution to journalArticle

Smith, Carl Vernon ; Rayburn, William F. ; Connor, Robert E. ; Fredstrom, Glen R. ; Phillips, Corinne B. / Double-blind comparison of intravaginal prostaglandin E2 gel and "chip" for preinduction cervical ripening. In: American Journal of Obstetrics and Gynecology. 1990 ; Vol. 163, No. 3. pp. 845-847.
@article{3ace90504552454ca279616dadec0923,
title = "Double-blind comparison of intravaginal prostaglandin E2 gel and {"}chip{"} for preinduction cervical ripening",
abstract = "The intravaginal application of prostaglandin E2 for preinduction cervical ripening has proved to be advantageous in the management of patients with an unfavorable cervix. The purpose of this double-blind randomized investigation was to compare the efficacy and safety of two method of prostaglandin E2 delivery. Patients who were to have preinduction cervical ripening because of an unfavorable cervix (Bishop score ≤4) were randomly assigned to be given a single dose of prostaglandin E2 as either 2.5 mg of gel or a 3.0 mg {"}chip{"} intravaginally in a placebo-controlled manner. Sixty-nine patients received the active prostaglandin E2, 34 in the gel group and 35 in the {"}chip{"} group. The groups were similar in maternal age, race, parity, gestational age, and initial Bishop score. Both forms of prostaglandin E2 were easy to administer and helpful in priming an unfavorable cervix. The need for, duration of, and maximum dose of oxytocin were similar in both groups. Cesarean delivery because of failed induction occurred in 5 of 35 (14.3{\%}) patients receiving a {"}chip{"} and 4 of 34 (11.8{\%}) receiving the gel. However, patients receiving a {"}chip{"} experienced a 20{\%} ( 7 35) incidence of hyperstimulation, compared with 2.9{\%} ( 1 36) in those receiving the gel (p < 0.05). The only case requiring immediate cesarean delivery because of intractable uterine hyperstimulation received a {"}chip{"}. We conclude that both methods were effective for cervical ripening, but the lower incidence of uterine hyperstimulation seen with the gel would suggest that it is preferable to the {"}chip{"}.",
keywords = "Prostaglandin E, cervical ripening, induction of labor",
author = "Smith, {Carl Vernon} and Rayburn, {William F.} and Connor, {Robert E.} and Fredstrom, {Glen R.} and Phillips, {Corinne B.}",
year = "1990",
month = "1",
day = "1",
doi = "10.1016/0002-9378(90)91081-M",
language = "English (US)",
volume = "163",
pages = "845--847",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Double-blind comparison of intravaginal prostaglandin E2 gel and "chip" for preinduction cervical ripening

AU - Smith, Carl Vernon

AU - Rayburn, William F.

AU - Connor, Robert E.

AU - Fredstrom, Glen R.

AU - Phillips, Corinne B.

PY - 1990/1/1

Y1 - 1990/1/1

N2 - The intravaginal application of prostaglandin E2 for preinduction cervical ripening has proved to be advantageous in the management of patients with an unfavorable cervix. The purpose of this double-blind randomized investigation was to compare the efficacy and safety of two method of prostaglandin E2 delivery. Patients who were to have preinduction cervical ripening because of an unfavorable cervix (Bishop score ≤4) were randomly assigned to be given a single dose of prostaglandin E2 as either 2.5 mg of gel or a 3.0 mg "chip" intravaginally in a placebo-controlled manner. Sixty-nine patients received the active prostaglandin E2, 34 in the gel group and 35 in the "chip" group. The groups were similar in maternal age, race, parity, gestational age, and initial Bishop score. Both forms of prostaglandin E2 were easy to administer and helpful in priming an unfavorable cervix. The need for, duration of, and maximum dose of oxytocin were similar in both groups. Cesarean delivery because of failed induction occurred in 5 of 35 (14.3%) patients receiving a "chip" and 4 of 34 (11.8%) receiving the gel. However, patients receiving a "chip" experienced a 20% ( 7 35) incidence of hyperstimulation, compared with 2.9% ( 1 36) in those receiving the gel (p < 0.05). The only case requiring immediate cesarean delivery because of intractable uterine hyperstimulation received a "chip". We conclude that both methods were effective for cervical ripening, but the lower incidence of uterine hyperstimulation seen with the gel would suggest that it is preferable to the "chip".

AB - The intravaginal application of prostaglandin E2 for preinduction cervical ripening has proved to be advantageous in the management of patients with an unfavorable cervix. The purpose of this double-blind randomized investigation was to compare the efficacy and safety of two method of prostaglandin E2 delivery. Patients who were to have preinduction cervical ripening because of an unfavorable cervix (Bishop score ≤4) were randomly assigned to be given a single dose of prostaglandin E2 as either 2.5 mg of gel or a 3.0 mg "chip" intravaginally in a placebo-controlled manner. Sixty-nine patients received the active prostaglandin E2, 34 in the gel group and 35 in the "chip" group. The groups were similar in maternal age, race, parity, gestational age, and initial Bishop score. Both forms of prostaglandin E2 were easy to administer and helpful in priming an unfavorable cervix. The need for, duration of, and maximum dose of oxytocin were similar in both groups. Cesarean delivery because of failed induction occurred in 5 of 35 (14.3%) patients receiving a "chip" and 4 of 34 (11.8%) receiving the gel. However, patients receiving a "chip" experienced a 20% ( 7 35) incidence of hyperstimulation, compared with 2.9% ( 1 36) in those receiving the gel (p < 0.05). The only case requiring immediate cesarean delivery because of intractable uterine hyperstimulation received a "chip". We conclude that both methods were effective for cervical ripening, but the lower incidence of uterine hyperstimulation seen with the gel would suggest that it is preferable to the "chip".

KW - Prostaglandin E

KW - cervical ripening

KW - induction of labor

UR - http://www.scopus.com/inward/record.url?scp=0025116436&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025116436&partnerID=8YFLogxK

U2 - 10.1016/0002-9378(90)91081-M

DO - 10.1016/0002-9378(90)91081-M

M3 - Article

VL - 163

SP - 845

EP - 847

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 3

ER -