OBJECTIVE  : To compare the outcome of induction of labour using a single versus two doses of prostaglandin E, vaginal gel.

Design : In this hospital based  study , we selected 200 with viable singleton pregnancies , cephalic presentation at term without previous history of caesarean section & Bishop score < 6

100 women had single PGE2 vaginal gel induction . A Hundred needed a repeat PGE2 vaginal gel induction after 6 hours of first application. ( the second being given after six hours ,if labour had not started or the cervix was still unripe) Amniotomy and oxytocin titration were performed when necessary for both protocols.

SETTING : A tertiary care medical college hospital annually delivering > 12000 women.

Results: Single versus double prostaglandin doses resulted in the need for oxytocin augmentation (80% vs 61%).Overall rate of mode of delivery compared, normal delivery 59% and 75% in the single vs double application  groups respectively, cesarean rates were 27 % and 20% in single vs double application groups respectively and was less in double group. The mean length of labour  was greater in double application group than the single Dinoprostone gel  ( 3.03 hrs vs 3.78 hrs) in primigravida  

CONCLUSIONS: Induction of labour with prostaglandin E2 vaginal gel in women reduces the cesarean rates and` does not adversely affect maternal and immediate neonatal outcome.