Hernández-Castro F, Álvarez-Chávez LD, Martínez-Gaytán V, Cortés-Flores R

Language: Spanish
References: 17
Page: 191-194
PDF size: 99.62 Kb.

ABSTRACT

Background: the rutinary labor induction with prostaglandin E2 (PGE2) in pregnancy at 41 weeks has showed a fetal benefit without an increase in maternal morbidity or cesarean delivery.
Objective: to show that the ambulatory management of prolonged pregnancy with PGE2 gel decreases the cesarean delivery and prenatal morbidity rates.
Methods: quasiexperimetal study of patients with an accurate dated pregnancy of 41 weeks and beyond were analyzed. The women were divided in two groups of 196 each one. In the treated group, the endocervical application of PGE2 was followed by cardiotocographic control. If there was no reason to interrupt the pregnancy they were evaluated twice a week. Perinatal outcomes, mode of delivery and indications for cesarean section were assessed in both groups.
Results: there was a decrease in rate of cesarean delivery in treated group, 43% versus 54% in control group (p ‹< 0.05). Apgar score at 1 and 5 minute showed no difference, but there were two intrauterine deaths in control group. The indications for cesarean surgery were the same in both groups and there was a case of tachysystole in each one.
Conclusion: we concluded that decrease in the rate of cesarean deliveries without increments of fetal and maternal morbidity in this study, point to a secure management choice with PGE2 in ambulatory patients.

REFERENCES

1. Dayson DC, Miller PD. Management of prolonged pregnancy: induction versus antepartum testing. Am J Obstet Gynecol 1987;156:928-934.

2. Mackenzie IZ. The unripe cervix and its management for labor induction. Am Acad Med 1993;21:151-157.

3. Brindley BA, Sokol RJ. Induction and augmentation of labor: Basis and methods for current practice. Obstet Gynecol Surv 1988;43: 740-743.

4. Rayburn WF. Prostaglandin E2 gel for cervical ripening and induction of labor: a critical analysis. Am J Obstet Gynecol 1989;160:529-534.

5. Moreno JD, Márquez MA, Reyes Y. Evaluación abierta de dinoprostona de liberación prolongada, con sistema de recuperación en la maduración del cérvix desfavorable en la inducción del parto por indicación médica u obstétrica. Ginecol Obstet Mex 1999;67:302-307.

6. Bernstein P, Leyland N, Gurland P. Cervical ripening and labor induction with prostaglandin E2 gel: A placebo-controlled study. Am J Obstet Gynecol 1987;156:336-340.

7. Liggins GC. Ripening of the cervix. Semin Perinatol 1978;2:261-271.

8. Chanrachakul B, Herabutya Y, Punyavachira P. Randomized comparison of glyceryl trinitrate and prostaglandin E2 for cervical ripening at term. Obstet Gynecol 2000;96:549-553.

9. Comité de Seguridad de Medicamentos de Uso Humano. Nota informativa del Comité de seguridad de medicamentos de uso humano acerca del Prepidil gel. Disponible en http:// www.msc.es./agemed/csmh/notas/prepidildic99.asp

10. Hollis B. Prolonged pregnancy. Curr Opin Obstet Gynecol 2002;14:203-207.

11. García A, Chávez J, Jiménez G, Izquierdo J, Luna S. Modificaciones cervicales inducidas con PGE2. Ginecol Obstet Mex 1990;58:8-13.

12. Werner PL, Walther K. Cervical ripening and induction of labor by intracervical and extra amniotic prostaglandin gel application in cases of intrauterine fetal death. Int J Gynecol Obstet 1985;23:387-394.

13. Calder A. Ripening of the cervix with extra amniotic prostaglandin E2 in viscous gel before induction of labor. Br J Obstet Gynecol 1977; 84:264-268.

14. Loria M, Lemus M, Kably A. Valoración del uso de prostaglandinas E2 en la maduración cervical. Ginecol Obstet Mex 1989;57:193-195.

15. De la Jara-Díaz J, Flores H, Escobedo F, Ahued- Ahued J. Embarazo prolongado. Ginecol Obstet Mex 1990;58:133-137.

16. Buttino L, Garite T J. Intracervical prostaglandin in postdate pregnancy. J Reprod Med 1990;35:155-158.

17. American College of Obstetricians and Gynecologists. Management of post-term pregnancy. Washington: ACOG Pract Bull 2004;104:(55) 639-646.