Nasal Administration of Prostaglandins for Uterine Stimulation and Induction of Labour

Fifty pregnant women were included in the present work in 3 groups. Group I comprised 24 women with intrauterine fetal death with the objective of screening the effect of various doses of 3 prostaglandins (PGs, E 2 , F 2α and Sulprostone ® ) administered intranasally with simultaneous recording of uterine activity by intrauterine microballoon. A dose response correlation regarding uterine stimulation was recorded for PGE 2 and Sulprostone ® but the former induced marked nasal irritation. Group II included 16 normal near term pregnant cases who were given nasal Sulprostone ® drops to detect the optimal safe dosage regimen as judged by cardiotocographic recordings. The results indicated that 250–500 μg can be safely given in repeated doses for uterine stimulation. In Group III, 10 primigravidae received intranasal drops of Sulprostone ® with an initial dose of 250 μ to induce labour for valid medical indications. Uterine activity and Bishop score increased significantly and labour was successfully induced in 9 cases. No maternal or fetal distress was recorded. This mode of Sulprostone ® delivery in relatively low doses appears to have desirable advantages and minimal risks.