Thompson 1987.
| Methods | Report on 2 studies. 1: Randomized trial: Intravaginal PGE2 gel and intravenous oxytocin with amniotomy. 2: Questionnaire sent to women included in study, one year later to evaluate patient satisfaction with method of induction. | |
| Participants | Participants: 52 women. Inclusion criteria: Bishop score 4+. Exclusion criteria: Asthma; glaucoma; raised intraocular pressure; vaginal bleeding of uncertain aetiology; ruptured membranes; previous caesarean section; failed induction of labour in this pregnancy, labour; known hypersensitivity to PG. | |
| Interventions | Intervention 1: Amniotomy + intravenous oxytocin (Dose: 0.7‐1.4 mU/min infusion rate increased at intervals of 30 min; max 10 mu/min). Intervention 2: 1 mg PGE2(Prepidil ‐Upjohn) intravaginal ‐posterior fornix. Dose repeated if labour not established and membranes intact; dosage 1‐2mg. Amniotomy if indicated. |
|
| Outcomes | Included outcomes: Caesarean section; cervix unfavourable/unchanged after 12‐24 hours; epidural analgesia; instrumental vaginal delivery; meconium stained liquor. Other outcomes: Retained placenta. | |
| Notes | Patients excluded from trial if not in labour by 12 hours ‐ managed as failed induction. Data has been included for this review. Protocol violations: Multiple violations, inconsistent denominators. Second study: Information on patient satisfaction not included: 40 women questioned, 23 responders; non responders valuable in interpretation of results. | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Allocation concealment? | Unclear risk | B ‐ Unclear |
Amniotomy regarded as augmentation of labour if applied more than two hours after induction was started.
AROM = intentional rupturing of the membranes to stimulate labour or inspect the amniotic fluid CTG = electronic heart rate monitoring of the fetus D+W = a solution of sterile water with sugar (dextrose) for intravenous use in labour FHR = fetal heart rate IOL = induction of labour IUPC = intra uterine pressue catheter, which is a soft plastic/celastic catheter system that is inserted through the cervix into the uterus during labour to accurately measure the strength of contractions min = minutes max = maximum PET = positron emission tomography PG = prostaglandin ROM = rupture of membranes