Labor induction with intravaginal misoprostol versus intracervical prostaglandin E2 gel (Prepidil gel)

Article Abstract:

A prostaglandin E1 gel applied to the inside of the vagina may be more effective in inducing labor and less expensive than a prostaglandin E2 gel applied to the cervix. Researchers gave intravaginal prostaglandin E1 (misoprostol) gel to 49 pregnant women who needed to have labor induced and intracervical prostaglandin E2 (dinoprostone Prepidil) gel to 50 other patients. All women were at least 35 weeks' pregnant. Intravaginal prostaglandin E1 gel induced labor more quickly and provided shorter labors than did the intracervical prostaglandin E2 gel. Fewer doses were required among women receiving prostaglandin E1 gel. The cesarean delivery rate was 20% in both groups. Misoprostol overstimulated the uterus in 2% of the women but did not lead to undesirable outcomes.

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Prostaglandin E(sub)2 for cervical ripening: a randomized comparison of Cervidil versus Prepidil

Article Abstract:

A time-released, medicated, cervical suppository called Cervidil appears to be more effective in reducing time to cervical ripening and time in labor than a medicated gel called Prepidil. Both preparations, however, ultimately achieve their desired purpose. Thirty-seven women were given Cervidil and 36 matched women were given Prepidil to induce labor. Women delivered an average of 20.6 hours after Cervidil insertion and 26.4 hours after Prepidil application. Twenty-four percent of those given Cervidil did not require oxytocin to induce labor. All but 3% given Prepidil later required oxytocin.

Product/Service Evaluation, Synthetic prostaglandins E

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A double-blind comparison of the safety and efficacy of intravaginal misoprostol and prostaglandin E2 to induce labor

Article Abstract:

A synthetic hormone, misoprostol, may be more effective in inducing labor than the commonly used prostaglandin E2 (PGE2). One-hundred women were given either misoprostol or PGE2 intravaginally to induce labor. The dose was repeated as needed at 6, 24, and 30 hours. The group receiving misoprostol delivered within 24 hours more often than the other group, and fewer of the misoprostol group required more than two doses. No significant increase in adverse effects were seen with misoprostol compared with PGE2, and misoprostol costs less and stores more easily.

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