Induction of labour with prostaglandin E2 vaginal gel in women with one previous caesarean section

Objective: To study the outcome of induction of labour with prostaglandin E2 (PGE2) vaginal gel in those with one previous caesarean section. Design: One year prospective comparative study. Setting: A tertiary care Armed Forces Hospital, Muscat. Population: Forty-six women with one previous caesarean section (CS) underwent PGE2 vaginal gel induction (study group). Hundred women with previous CS had gone into spontaneous onset of labour (control group). Main outcome measures: Primary outcome measures are mode of delivery and uterine rupture. Others are neonatal outcome, indications for caesarean section, and complications like, postpartum haemorrhage and infectious morbidity. Results: Overall rate of vaginal delivery after caesarean section (VBAC) was 65.21% and 79% in the study and control groups, respectively. There were 7 cases of neonatal intensive care unit (NICU) admissions (7%) in the control group; however, none in the study group. Caesarean section done for foetal distress was 5/16 CS in the study group (31.25%) and 10/21 CS in the control group (47.61%). There were no cases of uterine rupture in both control and study groups. Conclusion: Induction of labour with prostaglandin E2 vaginal gel in women with one previous caesarean section does not significantly increase the risk of caesarean section rate or ruptured uterus and does not adversely affect immediate neonatal outcome