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Federación Mexicana de Ginecología y Obstetricia, A.C.

2025, Number 2

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Ginecol Obstet Mex 2025; 93 (2)

Comparison of two PGE1 schedules for induction of labor

Méndez A, Reyes O

Language: Spanish
References: 26
Page: 31-39
PDF size: 314.66 Kb.


ABSTRACT

Objective: To compare a 3-dose regimen with a maximum 6-dose regimen of prostaglandin E1 (PGE1) to determine which is more effective in achieving a favorable Bishop score without increasing the rate of cesarean section or adverse perinatal outcomes.
Material and Methods: A randomized, controlled, prospective study conducted between April and May 2018 at the Maternity Hospital of Santo Tomás, Panama. Statistical analysis was performed using the a2 chi-square test for qualitative variables and the Mann-Whitney U test for quantitative variables with a p ‹ 0.05.
Results: 314 patients were studied (group A: 3 doses [n = 161] and group B: [6 doses n = 153]). The baseline characteristics of the population were similar in both groups with respect to the reported variables. Analysis of the primary endpoint showed no significant difference in the doses of PGE1 required to achieve a favorable Bishop score [3 doses: 1-2 doses (0.79) versus 6 doses: 1-2 doses (1.10); p = 0.79]. There were also no differences in the number of cesarean sections [3 doses: 26.1% compared to 6 doses: 23.5%; RR: 1.11(0.75-1.63); p = 0.79] or in the duration of labor [3 doses: 7.7 h (4.7) compared to 6 doses: 7.1 h (4.5); p = 0.19].
Conclusions: The regimen of 25 mg misoprostol every 6 hours up to a maximum of 5 doses was shown to be safe for achieving labor. Although the 5-dose regimen was associated with a low incidence of maternal, perinatal and puerperal complications, there were few successful deliveries, so 4 doses appears to be a better choice in terms of the recommended total number of PGE1 doses before considering other options for cervical ripening.


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