Journal de la grossesse et de la santé infantile

Abstrait

Labor Induction in Primiparous Women and Women with an Unripe Cervix-1

Anna Thorbiornson, Tomislav Vladic and Ylva Vladic Stjernholm

Objective: To compare the efficacy and safety of oral prostaglandin in solution, vaginal prostaglandin gel and trans cervical catheter for labor induction in primiparous women and women with an unripe cervix. Design: A retrospective study. Methods: Data from original obstetric records at a university hospital in Sweden in 2012-2013. Results: In primiparous women, vaginal birth <24 h was achieved in 54% with oral prostaglandin, 71% with vaginal prostaglandin, and 71% with catheter, whereas caesarean section was needed in 25%, 41% and 26% respectively. In women with an unripe cervix, vaginal birth <24 h was achieved in 66% with oral prostaglandin, 79% with vaginal prostaglandin, and 77% with catheter, while caesarean section was carried out in 21%, 33% and 21% respectively. The induction to vaginal delivery interval was the shortest with catheter and the longest with oral prostaglandin. The rates of obstetric bleeding, chorioamnionitis, uterine hyper stimulation and neonatal asphyxia were comparable. Conclusion: Oral prostaglandin in solution was less effective than vaginal prostaglandin gel and transcervical catheter in achieving vaginal birth <24 h. However, oral prostaglandin and catheter were safer, since they resulted in fewer caesarean sections without increasing maternal morbidity or neonatal asphyxia.