A Comparison of Three Dosages of Prostaglandin E₂ Pessaries for Ripening the Unfavourable Cervix Prior to Induction of Labor

A study was planned to evaluate the effect of Prostaglandin E2 pessaries in three different dosages in ripening the unfavourable cervix prior to the induction of labor. A single dose of PGE2 as pessary in the three different dosages was administered into the posterior vaginal fornix to ripen an unfavourable cervix with a Bishop score less than or equal to 4 in 101 primigravid and 79 multigravid patients. The pessary containing 2 mgm was as effective as 3 mgm and 5 mgm PGE2 pessary in ripening the cervix, and the outcome of labor and fetal status were similar with the different dosages of PGE2. However, two multigravid patients who received 5 mg of PGEs pessary and one multigravid patient who received 3 mg of PGE2 pessary developed hypertonic uterine activity. None of the patients who received 2 mg PGE2 pessary developed any adverse effect on uterine activity.