Comparing efficiency and outcomes of propess (dinoprostone slow release pessary) and prostin gel as a method of inducing labour

Abstract

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