Oral prostaglandin E2 is no more effective than other methods of induction but has more adverse effects.
Induction of labour is sometimes considered beneficial in some clinical circumstances, e.g., when the baby is not growing properly, when there is pre-eclampsia or when gestation goes beyond the normal length of pregnancy. There are many varying methods used to try to stimulate labour including administration of drugs, mechanical methods such as sweeping of the membranes, and more natural methods like nipple stimulation and having sex. Care needs to be taken to balance the stimulation of labour without over-stimulating and causing the baby difficulties. Prostaglandin E2 (PGE2) is a hormone given either by mouth or by insertion through the vagina to prepare and stimulate the cervix and bring on labour. This review looked at oral PGE2 compared with no intervention, and compared with several other methods of induction. The review identified 19 studies involving 2688 women, looking at eight differing comparisons. The review found that none of the trials assessed the effectiveness of oral PGE2 in inducing labour, but overall the trials found that PGE2 caused more frequent gastrointestinal adverse effects, particularly vomiting. There were no clear advantages to oral PGE2 over other methods used to bring on labour, except that women may prefer a method that does not require an intravenous infusion. Over stimulation of the baby may possibly be a possible problem with PGE2, but the increased incidence of gastrointestinal side-effects do not favor its use.