Intracervical prostaglandins are effective compared to placebo, but appear inferior when compared to intravaginal prostaglandins.
The effect of pericervical PGE2 instillation on levels of maternal serum 13,14-dihydro-15-keto-PGF2 alpha and progesterone.
In a prospective, randomized study 30 post-term pregnant women with low cervical scores were treated by a pericervical application of either 3 ml of 0.9% saline or 3 ml of 0.9% saline containing 1.5 mg PGE2. Twelve patients in the PGE2 group and two in the placebo group were delivered within 24 h (P less than 0.001). Eight blood samples were taken from each patient and serum PGFM and progesterone levels were measured by radioimmunoassay. In the women in whom labor started, PGFM serum levels rose progressively and progesterone levels fell consistently as the cervix dilated. After successful induction with PGE2 the variations were more marked than with labor of spontaneous onset. The PGFM-rise after PGE2 treatment must be due to stimulation of endogenous PGF2 alpha production by local therapy.