Intracervical application of PGE2-gel combined with early intravenous infusion of oxytocin for induction of term labor in women with unripe cervix

Summary Fifty-four women with an unripe cervix at term were given 0.5 mg intracervical prostaglandin E₂ (PGE₂) gel. In 37 of them (70%) the cervix ripened within 5 h and seven of them were in labor at that time. Of the remaining 30 patients, 15 were randomly given an i.v. oxytocin infusion and 13 were delivered within 12 h. In 17 women (30%) the cervix was still unfavorable 5 h after PGE₂-gel application but seven of them had a favorable cervix when reassessed 24 h after PGE₂-gel instillation. All these patients went into labor with an i.v. infusion of oxytocin. The remaning 10 patients required another dose of PGE₂-gel and subsequent i.v. oxytocin. Only in two of these patients did induction fail so that delivery by Caesarean sections was required. All infants were born in good condition.