Induction of Labour with Prostaglandin E2 Vaginal Tablet in Women with Previous One Caesarean Section

Abstract

Objective: To evaluate the frequency of vaginal birth after induction of labour with vaginal tablet
prostaglandin E2 in women with previous one caesarean section.
Methods: Total 100 pregnant women was selected for the study with singleton, cephalic
pregnancy and history of previous one caesarean section at gestational age between 37 to 41
weeks. EFW was less than 3.7kg and Bishop Score was > 5. Cervical ripening was done with
PGE2 vaginal tablet Prostin E2(3mg) after initial CTG. These women were evaluated after 6
hours by Bishop Score. CTG was repeated, if reactive, 2nd dose of PGE2 vaginal tablet was
given. If patients went into labour after first or 2nd dose of prostin E2, labour was carefully
monitored by close one to one monitoring by vital signs, uterine contractions, FHR monitoring,
scar tenderness and Bishop score. Outcomes measured were frequency of VBAC(vaginal birth
after caesarean section), uterine rupture, neonatal outcome and frequency of emergency repeat
caesarean section.
Results: Mean age of pregnant women was 28.06 + 3.45 years. 64 patients delivered vaginally
and 36 delivered by emergency repeat caesarean section. Fetal distress was the main reason for
emergency repeat caesarean section (ERCS). There was one case of uterine rupture. Neonatal
outcome were measured by Apgar score, admission to nursery and survival rate. One baby died
in utero because of uterine rupture and another baby died in nursery on 2nd day of life due to
meconium aspiration syndrome. 98 babies were delivered with good Apgar score and survival
rate of 98% was found.
Conclusion: Our study concluded that prostaglandin E2 vaginal tablets are safe for inducing
labour in women with previous one caesarean section but it should be administered with caution.
Risk of uterine rupture is 1% in our study