Objectives To compare dinoprostone slow release pessary (propess) and gel (prostin) for induction of labour at term in nulliparous women. Method 100 case notes were reviewed with 50 women in both the propess and prostin groups, all were matched for age, BMI, parity, gestation and indications for induction. Results In the propess group, 62% of patients were induced with propess alone and the rest required additional doses of prostaglandin gel. 64% required artifi cial rupture of membranes and syntocinon augmentation. 52% of women in the propess group achieved a vaginal delivery. In the prostin group the majority of women needed 2 mg of prostin. 68% delivered vaginally. The Caesarean section rate for patients not in established labour was 8% in the propess group and 2% in the prostin group. In the propess group, the majority of patients took over 85 h from time of induction to delivery, compared to 13-24 h in the prostin group. Conclusion These preliminary data suggest that induction of labour with propess pessaries is a slower process, with a lower vaginal delivery rate and higher rate of failed inductions than using the traditional prostin gel. The longer time from induction to delivery and the price of propess compared to 2 mg prostin gel suggests this maybe a more expensive way to induce labour.group.bmj.com on August 21, 2015 -Published by http://fn.bmj.com/ Downloaded from

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Results 9% of women had a documented body mass index (BMI) greater than 30 at booking. 58% had a vaginal delivery (spontaneous or assisted). 5% of women being induced were aged over 40% and 50% had a vaginal delivery. 61% of the patient population were Caucasian, of whom 70% had a vaginal delivery. 19% were Asian and 56% of them delivered vaginally compared to 46% of the African population. 60% of primigravidae patients delivered vaginally compared to 85% of mutiparous patients. 16% were induced for hypertension, 40% for postmaturity, 9% for prolonged rupture of membranes and 15% for gestational diabetes, all achieving similar vaginal delivery rates. 43% of the diabetic patients were Asian. 88% required induction with prostaglandins, 9% by artifi cial rupture of membranes and 3% with syntocinon augmentation following spontaneous rupture of membranes. 40% of patients had a spontaneous vaginal delivery and 24% had an instrumental delivery. 36% of women had an emergency Caesarean, 15% for fetal distress, 13% for failure to progress and 8% for failure to enter established labour. Conclusion These data suggest that Caucasian ethnicity and multiparity were positive predictors for vaginal delivery, while BMI, indication for induction and maternal age over 40 did not infl uence mode of delivery.group.bmj.com on August 21, 2015 -Published by http://fn.bmj.com/ Downloaded from