Abstract :
Introduction: The aim of induction is to achieve successful vaginal delivery where continuation of
pregnancy is not desirable. Unfavourable cervix is one of the main causes of failed induction. Introduction
of prostaglandins has revolutionised the scenario of cervical ripening. More than one dose of Prosta glandin
E2 (PGE2) gel may be necessary to facilitate cervical ripening and increase the chances of vaginal delivery.
Materials and Methods: This retrospective study was done to find the efficacy of multiple instillations
of intravaginal Prostaglandin E2 gel and to compare the maternal and fetal outcome between the single
instillation group and multiple instillation group. The women who went into labour or achieved cervical
ripening with a single instillation of Prostaglandin E2 gel forms Group A. Those who required more than
one instillation of prostaglandin E2 gel forms Group B. Both groups were compared for specific parameters.
Results: Primigravidas required multiple instillations. Postdated pregnancy was the most common
indication for Induction of Labour. 45.2% of primis had only single dose and 54.8% required multiple
doses. About two third (77.8%) of multipara required only one dose and a third of multipara needed
multiple doses. In Group A 90.7% had vaginal delivery, 9.3% had Caesarean section. Group B 95.7% had
vaginal delivery and 4.3% had Caesarean section.
Conclusion: Though PGE2 0.5mg gel is recommended to be used intracervically, it is equally effective
intravaginally. Three doses of intravaginal PGE2 can be safely used without the risk of uterine
hyperstimulation. There is no increased fetal risk with multiple instillations of intravaginal PGE2 gel.
Keyword :
Prostaglandin E2, Bishops score, Induction of Labour, Hyperstimulation.