The influence of pre-induction vaginal prostaglandin E2 gel upon subsequent labour.

Eight hundred and three patients with singleton viable pregnancies and fetal cephalic presentation were given prostaglandin E2 in viscous gel by intravaginal instillation the evening before planned surgical induction. When the cervix was 'ripe', surgical induction was avoided in 65.9 per cent of primigravidae and 87.5 per cent of multigravidae; the administration of epidural analgesia was less frequent, the rate of spontaneous vaginal delivery greater, the Caesarean section rate lower, and the state of the newborn at delivery better than in those patients who required surgical induction. Side effects attributable to the prostaglandin gel were rare as were complications.