[Studies on the mechanism of human parturition].
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This article examines the research being done and the hypotheses that have been formulated to understand further those processes that act to initiate parturition in women.
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Orally administered PGE2 in tablet form was used to induce labour in a prospective trial on 57 patients. The prostaglandin was given in separate-hourly-dosis of 0,5 to 1,5 mg. The success rate of this oral induction was 93%. Frequency of acidotic and/or clinically depressed newborns and the incidence of active delivery reflected the unselected population. A precipitant labour was noted in one patient, while 23% showed symptoms of gastrointestinal side effects which were seen to be dosage dependent.
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Cervical ripeness was scored in nulliparous and parous women not in labor at term according to Bishop's pelvic score. The frequency distributions of the scores for the single criteria as well as of the total score reveal the problems of all those scoring systems caused by the grouping process as sequelae of the choice of width of the classes as well as of their limits. E.g. for cervical dilatation in none case 2 or 3 points had been reached and similar findings had to be stated concerning station of the presenting part. An other point of discussion erases from the results of the analysis for linear correlation of the single criteria between each other and between the single criteria and the total score. The total score is mostly influenced by the consistency (r = 0,81 in nulliparous and parous women) and the effacement (r = 0,80 and r = 0,81) of the cervix, whereas for dilatation and station lower correlation coefficients were found. In contrast, when labor had started spontaneously, even if the status of cervix was not advanced, a significant change in the correlative influence of the total score by the single criteria could be stated with high correlation coefficients for dilatation and station and lower one's for consistency and effacement.