The unripe cervix: Management with vaginal or extra-amniotic prostaglandin E2

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Abstract
Sixty-two primigravidae with an unripe cervix were randomly allocated to 2 treatment groups for induction of labour. Group I received a vaginal tablet of 3 mg prostaglandin E2 repeated if necessary after 18 and 24 hours. Amniotomy was performed when labour was established. Patients in group II received 450 μg prostaglandin E2 in Tylose gel administered into the extra-amniotic space, followed 18 hours later by amniotomy and intravenous oxytocin. The treatment regimen in group II produced a more reliable cervical ripening effect and rapid onset of labour than that of group I. Four patients in group I failed to go into labour after treatment with 3 vaginal tablets. There were no differences between the two groups in the duration of labour, mode of delivery or condition of the baby at birth.

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