A Comparison of Intravaginal PGF2α and Intravenous Oxytocin to Stimulate Labour after Membrane Rupture

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Abstract
A prospective randomized controlled trial of 202 patients was set up to examine the efficiency and safety of 40 mg of intravaginal prostaglandin F2 alpha (PGF2 alpha) in a tylose gel to stimulate labour after artificial or spontaneous membrane rupture. The control group received a standard intravenous oxytocin regimen. The PGF2 alpha treated group had a significantly shorter length of labour (6.2 +/- 3.6 hours) compared to the oxytocin group (7.5 +/- 4.3 hours) (p less than 0.05). The analgesic requirements were significantly reduced in the PGF2 alpha treated patients. In PGF2 alpha treated patients 46 of 105 required no analgesia whereas 17 of 97 oxytocin treated patients required no analgesia (p less than 0.001). There were similar reductions for epidural (p less than 0.005) and pethidine requirements (p less than 0.005). No differences were found between groups with regards mode of delivery. There were no adverse maternal side-effects associated with PGF2 alpha usage. A significant reduction (p less than 0.05) in the incidence of neonatal jaundice requiring phototherapy occurred in the PGF2 alpha group. Prostaglandin F2 alpha appears to be a safe, efficient and better alternative to intravenous oxytocin to stimulate labour in the presence of ruptured membranes, allowing ambulation, a reduction in length of labour and less need for analgesia and intravenous therapy.