Comparison of perinatal outcomes between controlled‐release dinoprostone vaginal delivery system (PROPESS) and metreurynter for cervical ripening in labor induction: A retrospective single‐center study in Japan

Abstract

Aim: This study aimed to compare the efficacy and safety of a controlled-release dinoprostone vaginal delivery system (PROPESS) and a metreurynter for labor induction. Methods: This retrospective case-controlled study included 117 pregnant women (51 and 66 in the PROPESS and metreurynter groups, respectively) who required labor induction after >37 weeks' gestation at Mie University Hospital between January 2018 and September 2020. The primary outcome was the success rate of vaginal delivery. The secondary outcomes were changes in the Bishop score from the first insertion of PROPESS or the metreurynter to removal, uterine hyperstimulation and non-reassuring fetal status during the first insertion, proportion of pregnant women who needed pre-delivery oxytocin after removal, time to vaginal delivery after the first insertion, proportion of pregnant women who delivered vaginally within 12 or 24 h after the first insertion, and neonatal outcomes. Results: The proportion of pregnant women, especially primiparas, who delivered vaginally was significantly higher in the PROPESS group (26/34 [76.5%]) than in the metreurynter group (25/52 [48.1%]; p = 0.01). Moreover, among multiparas in the PROPESS group who delivered vaginally, nine (56.3%) out of 16 women delivered vaginally within 3 h of labor onset. Conclusions: PROPESS for cervical ripening may reduce the risk of undergoing cesarean section in pregnant women requiring labor induction, especially primiparas. It is important to consider the possibility of precipitate labor when using the PROPESS in multiparas.

Clinical significances of Bishop score and vaginal bleeding to controlled‐release dinoprostone delivery system (PROPESS) efficacy for cervical ripening: A retrospective single‐center study in Japan

“…Therefore, only a few studies to date have reported the factors affecting the clinical efficacy of PROPESS in Japanese pregnant women. 2,5 Despite its clinical effectiveness, wide variability in the efficacy of dinoprostone has been noted among pregnant women. 6 Maternal age, gestational age, parity, and vaginal pH could influence the efficacy of dinoprostone in cervical ripening and labor induction/delivery.…”

“…PROPESS was at last approved by the Japan Ministry of Health, Labor, and Welfare in January 2020, and is the only choice for pharmacologic cervical ripening in Japan. Therefore, only a few studies to date have reported the factors affecting the clinical efficacy of PROPESS in Japanese pregnant women 2,5 …”

Influence of gestational diabetes mellitus on outcomes of preinduced labour with dinoprostone vaginal insert

“…Factors increasing a chance for effective labour induction using the insert include younger age, white and Asian race, a lower body mass index (BMI), multiparity, older gestational age, a condition post water breaking, and a greater cervical maturity according to Bishop's score [20]. The use of dinoprostone increases the percentage of natural childbirths versus mechanical methods, especially in primigravida women [21]. Other management regimes are also verified when dinoprostone proves to be ineffective.…”

Impact of Introducing a Controlled-Release Dinoprostone Vaginal Insert for Labor Induction: A Retrospective Single-Center Study in Japan

“…Many studies have compared the mechanical methods of ripening and PGs [1,3,5], and since its introduction in Japan, there have been several reports on CR-DVI [6][7][8][9][10]. However, it has only been a short time since its introduction in Japan, and it cannot be said that it has been fully investigated.…”