PGE2 induction of labor for consistent decreased perception of fetal movements at term

Objectives: To determine the effects of labor induction with vaginal prostaglandin E2 (PGE2) on mode of delivery and immediate neonatal outcome in women with consistent decreased perception of fetal movements at term. Methods: The study group consisted of 115 women with consistent perception of decreased fetal movements admitted for induction of labor at term. Findings were compared with those of 510 women with normal spontaneous onset of labor. Women with previous cesarean section (CS) were excluded from both the study and control groups. Results: The rate of CS was higher in the study group (14.8%) than in the control group (9%) (not significant). The rates of low 5-min Apgar score (less than or equal to7) and CS performed for non-reassuring fetal heart rate were two-fold higher in the study group than in the control group (2.6% vs. 1.2%, and 6.1% vs. 3.1%, respectively, not significant in both). Conclusion: Induction of labor with PGE2 is successful in approximately 85% of the patients with decreased perception of fetal movements at term and apparently with no serious maternal or fetal complications. However, these pregnancies might be at higher risk of perinatal complications. We suggest that active labor induction may be currently considered as the preferred strategy in these pregnancies. Large prospective randomized studies on maternal and neonatal outcome are needed to clarify this issue. (C) 2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved.