The outcome of stimulation of labour in 219 primiparous patients with more than 6 hours following a premature
rupture of the membranes, and with an ripe cervix, without the established labour, was analysed according to the mode of treatment. One hundred and thirty eight (138) women received
PGE2 peroral
tablets, 14 intracervical
PGE2 gel, and 67
oxytocin intravenously. There were 73.2% vaginal deliveries in the group that received
PGE2 per os, 77.5% in the group that received
oxytocin, and 92.9% in the group that was given intracervical gel. The differences were significant. The cervix remained unripe in 9.4% patients that received
PGE2 perorally, in 14.9% of those that received
oxytocin, while in the gel group it became favourable in all parturients. Uterine polisistoly was encountered in 10.9% labours after peroral stimulation, in 7.1% in the gel group and in 1.5% in the
oxytocin group, and perinatal
asphyxia in 16.7%, 7.1% and 13.4%, respectively. When too frequent, especially if combined with
oxytocin and given to patients with a moderately favourable cervix, peroral stimulation predisposes to uterine polisitoly. Intracervical application of
PGE2 gel is the method of choice in primigravid patients with a premature
rupture of the membranes and the unripe cervix (Bishop score O). In gravidas with a more favourable cervix (Bishop score 4-6) the administration of
oxytocin is acceptable with less complications. In those with a moderately favourable cervix (Bishop score 1-4) the gel application proved to be preferable, although stimulation could be carried out as well.