Comparison of the Response of Oxytocin Versus Prostaglandin E2 Vaginal Pessary for Labour Induction in Prelabour Rupture of Membranes

Objective: To compare the response of oxytocin versus prostaglandin E2 vaginal pessary for labour induction in prelabour rupture of membranes at term in primigravida patients with poor Bishop score. Design: It was a prospective comparative study. Setting: The study was conducted in the department of Gynae & Obs, Ittefaq hospital (Trust), Lahore during a period of one year i.e from July 2007 to June 2008. Patients and Methods: Fifty primigravidae with prelabour rupture of membranes at term having Bishop score < 5 or 5 were randomized into 2 groups to undergo induction of labour with either oxytocin or prostaglandin E2 vaginal pessary. Main outcome measures were induction-initiaton of labour interval, induction-delivery interval, maternal complications during induction, mode of delivery, fetal outcome and total hospital stay. Results: The induction-initiation of labour interval (P=0.005), duration of improvement in Bishop score, induction-delivery interval (P=0.011) and total hospital stay (P=0.018) were shorter in PGE2 induced patients. Moreover, majority of the patients delivered vaginally, had no maternal complications, did not require augmentation of labour, had less evidence of fetal distress (P=0.011) and better APGAR score at birth in this group. Majority of the neonates in the 2 groups did not require admission in neonatology unit (P=0.666). Conclusion: Prostaglandin E2 vaginal pessaries are very safe and effective to stimulate labour with ruptured membranes and poor Bishop score.