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  • Title: Uterine priming with oral prostaglandin E2 prior to elective induction with oxytocin.
    Author: Golbus MS, Creasy RK.
    Journal: Prostaglandins; 1977 Sep; 14(3):577-81. PubMed ID: 333516.
    Abstract:
    Fifty pregnant women at term, with a cervix unfavorable for induction, were electively induced with intravenous oxytocin after priming with either oral prostaglandin E2 or a placebo. Oral PGE2 was effective in increasing the Bishop score and in inducing labor prior to the induction, but did not increase the incidence of successful inductions. 50 pregnant women were included in a double-blind study aimed at determining whether oral prostaglandin E2 (PGE2) can effectively prime an unripe cervix prior to oxytocin induction of labor. Study participants ranged in age from 20-37 years and were 36-41 weeks pregnant. Patients were randomly assigned to receive either PGE2 or a placebo. 2 tablets were administered at 3 hour intervals for 3 doses. Oxytocin infusion began 9-11 hours after the 3rd dose of oral medication and was increased until adequate uterine contractions were induced. No difference in the frequency of contractions was seen in the 2 groups during priming; however, PGE2 patients showed a 2 point advance in Bishop score, which was significantly greater than the 0.7 change in the control group. The most striking finding was that 6 women in the PGE2 group, compared with 1 in the placebo group, went into active labor during the priming phase and delivered without induction. Oxytocin failed to induce effective labor in 9 patients in each group. There was no difference between the 15 control and 10 PGE2 patients successfully induced in terms of duration or dosage of oxytocin. However, the more inducible patients in the PGE2 group may have begun labor before oxytocin induction, rendering the groups less equivalent for the induction part of the study. These results suggest that oral PGE2 priming results in an easier course to delivery, although not in a higher incidence of successful induction. It is recommended that the PGE2-oxytocin induction regimen be studied in patients at various stages of induction, perhaps with an increased dosage of PGE2 or a shorter interval between dosages.
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