Aim To see the efficacy and safety of use of >6 mg vaginal prostaglandin E₂ (PGE₂) tablets (More than two prostins) when used within 24 h in term labour inductions.

To assess the failed induction rates in cases where three prostins were used.

To analyse the percentage of women induced but failed to progress in first or second stage of labour.

Methods Retrospective case notes analysis of 90 women, who underwent labour induction with vaginal PGE₂ tablets of 3 mg each from 2005 to 2008 at Cumberland Infirmary.

Results Among 1039 women, 90 had 3 prostins. The vaginal delivery rate was 48%. The spontaneous vaginal deliveries were achieved in 36% and assisted vaginal deliveries in 12%.

Of 90 women, 47 (52%) women had Caesarean section. Failed induction of labour was noted in 27 women (58%) after using three prostins. 17% didn't progress in first stage of labour, while 6% failed to progress in second stage of labour. Emergency Caesarean section was performed in 17%, of those, seven had Caesarean section because of pathological cardiotocograph and one woman had due to severe pre-eclampsia.

Discussion The use of three prostins in 24 h of start of labour induction in term deliveries is a good practice. The authors achieved vaginal deliveries in almost half of women induced.

The reasons for higher Caesarean section rate was mainly because of failed induction while the second most common reason was failure to progress in first stage of labour, again because of poor bishop score or high fetal head.