LABOR INDUCTION WITH INTRAVAGINAL MISOPROSTOL VERSUS INTRACERVICAL PROSTAGLANDIN E(2) GEL (PREPIDIL GEL) - RANDOMIZED COMPARISON

OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginal prostaglandin E(1), misoprostol, with that of intracervical prostaglandin E(2) (Prepidil gel) for labor induction. STUDY DESIGN: One hundred three patients with an indication for induction of labor were randomly assigned to induction with prostaglandin E(1), 50 mu g intravaginally, or with Prepidil gel, 0.5 mg intracervically, every 4 hours until active labor. RESULTS: Four patients were excluded, leaving 49 patients who received prostaglandin E(1) and 50 who received prostaglandin E(2). The time from start of induction to vaginal delivery was significantly shorter in the prostaglandin E(1) group (11.4 vs 18.9 hours, p < 0.001), and fewer patients in the prostaglandin E(1) group required oxytocin augmentation (23% vs 55%, p < 0.005). No significant differences were noted in mode of delivery or in adverse maternal, fetal, or neonatal effects. CONCLUSION: Intravaginal prostaglandin E(1) is a more effective, lower-cost agent for induction of labor than is intracervical prostaglandin E(2) gel and is comparable in safety.