Role of Prostaglandin in Induction of Labor in Patients with Poor Bishop Score
DOI:
https://doi.org/10.70749/ijbr.v3i4.2398Keywords:
Bishop score, Cervical ripening, Labor induction, Prostaglandins, Uterine contractionAbstract
Background: Low Bishop score is a sign of an adverse cervix and is significantly linked to labor induction failure. Prostaglandins have been increasingly employed to address this dilemma as they induce cervical ripening and uterine contractility to enhance successful vaginal discharge. Creation of local evidence is necessary in order to authenticate their application in varied clinical scenarios. Objective: To evaluate the efficacy of prostaglandin for induction of labor in women presenting with a poor Bishop score. Study Design: Quasi-experimental study. Duration and Place of Study: The study was carried out from July 2024 to December 2024 at the Department of Obstetrics and Gynecology, Ayub Teaching Hospital, Abbottabad. Methodology: A total of 118 women aged 18 to 40 years with singleton pregnancies beyond 37 weeks and an unfavorable Bishop score of five or less were included. Exclusion criteria were previous cesarean section, contraindications to prostaglandin use, abnormal fetal presentation, uterine pathology, or non-reassuring fetal status. Labor was induced with intravaginal prostaglandin E2 gel, administered up to three times within 24 hours. Efficacy was defined as achievement of vaginal delivery within 24 hours after induction. Results: The mean age of participants was 28 years and the mean gestational age was 39 weeks. Among 118 cases, successful vaginal delivery occurred in 100 women (84.7%), while 18 women (15.3%) failed to respond to induction. No significant association was found between efficacy and demographic factors. Conclusion: Prostaglandin is an effective agent for labor induction in women with poor Bishop scores, achieving high rates of successful vaginal delivery.
Downloads
References
1. Kuba K, Kirby MA, Hughes F, Yellon SM. Reassessing the Bishop score in clinical practice for induction of labor leading to vaginal delivery and for evaluation of cervix ripening. Placenta Reprod Med. 2023;2:8.
https://doi.org/10.54844/prm.2023.0353
2. Mlodawski J, Mlodawska M, Plusajska J, Detka K, Bialek K, Swiercz G. Repeatability and reproducibility of potential ultrasonographic Bishop score parameters. J Clin Med. 2023;12(13):4492.
https://doi.org/10.3390/jcm12134492
3. Dîră L, Drăguşin RC, Şorop-Florea M, Tudorache Ş, Cara ML, Iliescu DG. Can we use the Bishop score as a prediction tool for the mode of delivery in primiparous women at term before the onset of labor? Curr Health Sci J. 2021;47(1):68-74.
https://doi.org/10.12865/CHSJ.47.01.11
4. Sinha A, Sinha M, Sharma SK, Prasad D, Goel N, Kumari M. A comparative study between modified Bishop score and transvaginal sonography to predict successful induction of labor. J Family Med Prim Care. 2024;13(10):4438-4443.
https://doi.org/10.4103/jfmpc.jfmpc_358_24
5. Viteri OA, Sibai BM. Challenges and limitations of clinical trials on labor induction: a review of the literature. AJP Rep. 2018;8(4):e365-e378.
https://doi.org/10.1055/s-0038-1676577
6. Newman RB, Goldenberg RL, Iams JD, Meis PJ, Mercer BM, Moawad AH, et al. Preterm prediction study: comparison of the cervical score and Bishop score for prediction of spontaneous preterm delivery. Obstet Gynecol. 2008;112(3):508-15.
https://doi.org/10.1097/AOG.0b013e3181842087
7. Tadesse T, Assefa N, Roba HS, Baye Y. Failed induction of labor and associated factors among women undergoing induction at University of Gondar Specialized Hospital, Northwest Ethiopia. BMC Pregnancy Childbirth. 2022;22(1):175.
https://doi.org/10.1186/s12884-022-04476-7
8. de Vaan MD, Ten Eikelder ML, Jozwiak M, Palmer KR, Davies-Tuck M, Bloemenkamp KW, et al. Mechanical methods for induction of labour. Cochrane Database Syst Rev. 2023;3(3):CD001233.
https://doi.org/10.1002/14651858.CD001233.pub4
9. Li SF, Ju HH, Feng CS. Effect of cervical Bishop score on induction of labor at term in primiparas using Foley catheter balloon: a retrospective study. BMC Pregnancy Childbirth. 2024;24(1):401.
https://doi.org/10.1186/s12884-024-06600-1
10. Sanchez-Ramos L. Methods for the induction of labor: efficacy and safety. Am J Obstet Gynecol. 2024;230(3):S669-S695.
https://doi.org/10.1016/j.ajog.2022.11.117
11. Chiossi G, Costantine MM, Bytautiene E, Kechichian T, Hankins GD, Sbrana E, et al. The effects of prostaglandin E1 and prostaglandin E2 on in vitro myometrial contractility and uterine structure. Am J Perinatol. 2012;29(8):615-22.
https://doi.org/10.1055/s-0032-1311986
12. Malik A, Irfan S, Yousuf F, Amerjee A, Naz S, Virji S. Comparison of pre and post Foley catheter Bishop's score: a retrospective record review at Aga Khan University Hospital Karachi, Pakistan. Pak J Med Sci. 2024;40(1Part-I):73-77.
https://doi.org/10.12669/pjms.40.1.7433
13. Bakker R, Pierce S, Myers D. The role of prostaglandins E1 and E2, dinoprostone, and misoprostol in cervical ripening and the induction of labor: a mechanistic approach. Arch Gynecol Obstet. 2017;296(2):167-179.
https://doi.org/10.1007/s00404-017-4418-5
14. Kemp B, Winkler M, Rath W. Induction of labor by prostaglandin E2 in relation to the Bishop score. Int J Gynaecol Obstet. 2000;71(1):13-7.
https://doi.org/10.1016/s0020-7292(00)00253-8
15. Raza F, Majeed S. Intracervical PGE2 gel for cervical ripening and induction of labour. Pak J Med Sci. 2008;24(2):241-5.
16. Gupta S, Kuntal N, Gupta VK. Maternal and fetal outcomes with the use of prostaglandins E2 as a cervical ripening agent for induction of labour. Int J Reprod Contracept Obstet Gynecol. 2020;9(1):44-7.
https://doi.org/10.18203/2320-1770.ijrcog201959
17. Afridi F, Bibi R, Qadir M, Wazir R. Effectiveness of intracervical Foley's catheter with PGE2 versus PGE2 alone for induction of labour at term pregnancy. J Bahria Univ Med Dent Coll. 2023;13(2):130-4.
https://doi.org/10.51985/JBUMDC2020018
18. Qazi Q, Fatima SS, Wahab S, Syed W. Efficacy of misoprostol and prostaglandin E2 gel for induction of labor in term pregnancy. J Postgrad Med Inst. 2019;33(4):331-6.
19. Ilyas A, Mir MK, Hanif S. Comparison of oral misoprostol with PGE2 gel for induction of labour in PROM at term with unfavourable Bishop score. Pak J Med Health Sci. 2016;10(2):409-12.
20. Sher Z, Ashraf M, Irum N, Bashir S, Khaliq N, Yaqub S. Concurrent oxytocin in women needing second dinoprostone. J Coll Physicians Surg Pak. 2015;25(5):350-3.
21. Qamar S, Bashir A, Ibrar F. Comparison of prostaglandin E2 gel, prostaglandin E2 pessary and extra-amniotic saline infusion with oxytocin for induction of labour. J Ayub Med Coll Abbottabad. 2012;24(2):22-5.
22. Michail A, Fasoulakis Z, Domali E, Daskalakis G, Antsaklis P. Role of the Bishop score in predicting successful induction of vaginal delivery: a systematic review of current evidence. Cureus. 2025;17(7):e87467.
https://doi.org/10.7759/cureus.87467
23. Agha S, Wasim T, Wasim AZ, Agha R, Sibtain S. Induction of labour with prostaglandin E2 vaginal tablet in women with previous one caesarean section. Esculapio. 2016;12(2):66-9.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
