Oral versus vaginal prostaglandin for labor induction.

Objective: To compare the efficacy and safety of oral prostaglandin (PG) in solution versus vaginal PG gel for labor induction.

Design: A retrospective study.

Methods: Data from original obstetric records at a university hospital in Sweden 2012-2013.

Results: In all women, oral PG resulted in vaginal birth (VB) < 24 h in 66% compared to 80% with vaginal PG (p < 0.001), and cesarean section (CS) in 19% versus 32% (p = 0.02). In primiparous women, oral PG was followed by VB  <24 h in 54% compared to 71% (p = 0.01), and CS in 25% versus 41% (p = 0.03). In women with an unripe cervix, oral PG lead to VB  <24 h in 66% compared to 79% (p = 0.01), and CS in 21% versus 33% (p = 0.04). Despite a longer induction to vaginal delivery interval with oral PG, the rates of obstetric bleeding, chorioamnionitis, and neonatal asphyxia were not increased.

Conclusions: Oral PG in solution was less effective than vaginal PG gel in achieving VB  <24 h. However, oral PG was safer, since it resulted in fewer CSs without increasing maternal morbidity or neonatal asphyxia.