Intracervical prostaglandins are effective compared to placebo, but appear inferior when compared to intravaginal prostaglandins.
[Contribution of intracervical PGE2 administration in premature rupture of the membranes at term. Prospective randomised clinical trial].
To compare the clinical effectiveness and safety of intracervical dinoprostone versus conservative management of term prelabor rupture of membranes.
                88 women with term prelabor rupture of membranes were assigned randomly to one of two groups
                44 women were allocated in each group. The means (+/- S. D) intervals from PROM to delivery and from inclusion to start of labour were significantly shorter in the dinoprostone group (19.5+/-6.2 vs 25.5+/-7.7 hours p<0.01 and 8.7+/-5.5 hours vs 14+/-6. 8; p=0.32 respectively). No significant differences were observed in the mean duration of labour (4.5+/-1.6 hours vs. 4.9+/-1.67 p=0.32). The rates of clinical amniotits were 15.9% in the dinoprostone group and 6.8% in the control group; difference is not statistically significant (p=0.17). The mode of delivery and Apgar score were similar in the two groups. Uterine tachysystole occurred more frequently in the dinoprostone group (6.8 vs 0%) but did not reach statistical significance.
                Intracervical administration of dinoprostone with prelabor rupture of membrane at term and unripened cervix shortens the interval to delivery without a significant increase of maternal or neonatal morbidity.