Extra‐amniotic saline infusion versus extra‐amniotic prostaglandin F2α for cervical ripening and induction of labor

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Abstract
Objective: To compare the effectiveness of extra-amniotic saline infusion versus extra-amniotic prostaglandin F2α for cervical ripening, induction of labor and achievement of vaginal delivery in patients with unfavorable cervices. Method: A randomized trial of extra-amniotic saline infusion versus extra-amniotic prostaglandin F2α performed at Harare Central Hospital Maternity Unit, Zimbabwe. One hundred and sixty-four patients were recruited from those referred to Harare Central Hospital Maternity Unit who required induction of labor for either maternal or fetal indications. Results: 162 patients (extra-amniotic PgF2α group, N=81; extra-amniotic saline infusion group, N=81) had complete information. Two patients (one from each group) were lost to follow up. The demographic characteristics of the patients and the indications for induction were not statistically different. There was a marginally statistically significant difference in the change of Bishop Score in favor of the extra-amniotic saline infusion (4.0, S.D.=1.4) as compared to (4.5, S.D.=1.5) for extra-amniotic PgF2α (P value=0.047). All other parameters showed no statistically significant differences. Maternal and fetal complications were minimal and not significantly different. Extra-amniotic saline infusion was however almost six times cheaper than PgF2α. Conclusion: Extra-amniotic saline infusion is as effective as PgF2α, safe, but much cheaper than PgF2α and should be seriously considered as a method of first choice in resource-poor settings.

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