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The use of prostaglandins for the induction of labor.


 This paper attempts to assess the present status of the use of prostaglandins (PGs) in induction of labor. According to the published literature over 1000 patients have been treated with intravenous administration of PGF2alpha, a method which seems to be at least as effective as oxytocin infusion. Some authors suggest that this mode of action may be more effective in patients with lower Bishop scores at start of infusion. Intravenous infusion of PGE2alpha has been found to be 10 times more potent than PGF2alpha, regardless of mode of administration; success rates and amount of side effects are similar. Oral administration of PGE2alpha has shown to be as effective as oxytocin in 786 elective inductions of labor; the oral way of administration is more effective in the latent and early active phase of labor. 15 methyl PGE, a chemically modified PG, is as effective as its parent compound, has the same side effects, can be used in smaller amounts, but does not have any major advantages over the natural compound. In general it takes less than 1/10 the dose of PG to initiate labor than it takes to induce abortion, and the side effects are reduced about the same degree; since PGs may cause hypertonus care should be taken in monitoring the fetal condition and in controlling the rate of PG administration. Considerable work is needed before the full value of PGs in induction of labor can be assessed.
