유도분만의 적용이 되는 각각 30명의 산모(초산부 15예, 경산부 15예)를 대상으로 각각 경구용 PGE₂는 경구로, 질용 PGE₂정제는 질후벽 자궁경관밑에 투여 하여 다음과 같은 결과를 얻었다. 1. 유도분만 성공율은 경구용 PG군에서 67%(20/30예)이었는데, 초산부 60%(9/l5예), 경산부 73%(11/15 예)이 있고, 질용 PG군에서는 77%(23/30)로 초산부 66%(10/15예) . 경산부 87%(13/15예)이었다. 2. 진통초발까지의 소요시간은 경구용 PG군에서 평균 7시간 13분, 질용 PG군에서 평균 4시간 45분이었으며, 투약개시부터 태아만출까지의 소요시간은 경구용 PG군에서 평균 18시간 37분, 질용 PG군에서 10시간 33분으로 진통초발시간과 태아만출까지의 소요시간이 질용 PG에서 월등히 빨랐다. 3. 경구용 PG군에서 정상질식분만은 70%, 질식흡인분만 23%, 제왕절개술 7%이었고 질용 PG군에서는 정상질식분만 80%, 질식흡인분만 17%, 제왕절개분만 3%이었다. 4. 경구용 PG군에서 분만된 신생아의 Apgar score는 1분에서 7이상이 90%(27/30예) , 5분에서 7이상이 100%이었고, 분만된 신생아가 태변염색된 경우는 17% (5/30예)이었다. 질용 PG군은 분만된 신생아의 Apgar score가 1분, 5분에서 모두 7~8이상으로 양호한 편이었고, 태변염색된 경우는 10%이었으며 특기할 만한 신생아의 이상소견은 발견할 수 없었다. 5. 경구용 PG에서 투약도중 나타난 부각용은 오심 10% (3/30예) , 구토 3% (1/30예)이었고 질용 PG군에서는 부작용이 없었다. 6. 경구용 PG와 Oxytocin정맥점적주입을 병용하여 시도한 유도분만 10예중 80%(8/10예) 에서 유도분만에 성공하였으므로 경구용 PG에 의한 총유도분만 성공율은 93% (28/30예) 이었고 질용 PG와 oxytocin정맥점적 주입을 병용한 7예증 6예에서 질식분만에 성공하였으므로 질용 PG에 의한 총유도분만성공율은 96.6%(29/30 예) 이었으며 1예에서만 제왕절개술이 시행되었다. 이상의 결과로 미루어 보아 경구용 PG나 질용 PG가 특별한 부작용이 없으면서 높은 유도분만성공율을 보이고 있으며 질용 PG가 경구용 PG보다 진통초발까지의 시간과 태아만출까지의 시간이 비교적 빠르게 나타났고 경산부에 비하여 성공율이 약간 떨어지는 초산부는 PG단독사용보다는 oxytocin정맥점적주입의 병용에 의한 유도분만으로 좋은 성과를 거둘 수 있다고 생각된다.

Intravaginal Prostaglandin E₂ on the Unfavorable Cervix Induction of labor for obstetrics or medical reasons is an integral part of modern obstetric practice. The standard method employed in the authors, institution has been amniotomy and intravenous oxytocin for many years while, during the last 2 or 3 years, oral administration of prostaglandin Es tablets has been used before intravenous infusion of oxytocin to induce labor as well as to ripen the cervix. Also a ideal method for the induction of labor would be simple, safe, effective and noninvasive, there by increasing acceptance by the patient and reducing the risks associated with amniotomy. The intravaginal administration of prostaglandin E₂ tables which is the easiest way to apply prostaglandin can provide these benefit. This is a report to compare the efficiency of oral PG for the induction of labor. Induction of labor was performed in the cases of each 30 women between 39th and 44th weeks of pregnancy who were admitted to the Dept. of Obstetrics and Gynecology of Kyung Hee Univ. Hospital from June 1981 to May 1983. The pelvic score for induction was determined by Bishop scoring method. and the Bishop score of the patient of our studies were all below 5. The result were as follows. 1. The success rate in induction with oral PGE₂ were 60% in primigravida(9 of 15 cases), 73%(11 of 15 cases) in multigravida. The success rate in induction with vaginal PGE₂ were 66%(10 of 15 cases) in primigravids, 87%(13 of 15 cases) in multigravida. 2. Mean induction delivery time of oral PGE₂ group was 18 hours 37 minutes and time interval from medication to active labour was 7 hours 13 minutes. Mean induction delivery time of vaginal PGE₂ group was 10 hours 33 minutes and time interval from medication to active labour was 4 hours 45 minutes 3. In oral PG group, normal vaginal delivery was 70%, vacuum delivery was 23%, cesarean delivery was 7%, In vaginal PG group, normal vaginal delivery was 80%, vacuum delivery was 17%, cesarean delivery was 3%. 4. In oral PG group, over 7(at 1 minutes) of Apgar score was 90%, over 7(at 5 minute) was 100% and meconium stained fetus was 17%(5 of 30 cases). In vagina1 PG group, over 7 of 8(at 1 and 5 minutes) of Apgar score was all and meconium stained fetus was 10%(3 of 30 cases). 5. In oral PG group, 11 of 12 cases(91%) of fetal monitoring patients showed reactive pattern. In vaginal PG group, 9 cases of fetal monitoring patients were all reactive pattern. Their NST results were all reactive and 4 of 9 cases were applicated with CST(their results were all negative) 6. Maternal side effects during oral PG induction were nausea(10%, 3 of 30 cases). vomiting(3%, 1 of 30 cases), but they were disappeared spontanecusly without specific treatment, and there was no side effects during vaginal PG induction. 7. In failed cases with only oral PG, successful induction rate with combined therapy of oral PG and oxytocin was 93%(23 of 30 cases) and 2 cases of cesarean delivery were carried out. In failed cases with only vaginal PG, successful induction rate with combined therapy of vaginal PGE₂ and oxytocin was 97%(29 of 30 cases) and only 1 case of cesarean section was carried out.