Comparison of the Dinoprostone Vaginal Insert and Dinoprostone Tablet for the Induction of Labor in Primipara: A Retrospective Cohort Study

Abstract

This retrospective study aimed to compare the safety and efficacy of Prostin E2 and Propess for the induction of labor (IOL) in nulliparous women between January 2018 and October 2021. The inclusion criteria were nulliparous, singleton, >37 weeks’ gestation, cephalic presentation with an unfavorable cervix (Bishop score ≤ 6), no signs of labor, and use of one form of dinoprostone (Prostin E2 or Propess) for IOL. The cesarean section (C/S) rate and induction-to-birth interval were the main outcome measures. In total, 120 women were recruited. Sixty (50%) patients received Propess and 60 (50%) received repeated doses of Prostin E2. The Prostin E2 and Propess groups had similar patient characteristics, but the Bishop score was significantly higher in the Propess group than in the Prostin E2 group; therefore, multivariate analysis was conducted, and the Bishop score was not associated with the induction-to-birth interval. The C/S rate was not significantly different between the two groups, but the Propess group achieved a shorter induction-to-birth interval, a higher rate of vaginal delivery in 24 h, and a lower number of vaginal examinations than the Prostin E2 group. Propess was effective and safe in IOL and could be an option for cervical ripening in nulliparous pregnancy.

The Association between Cervical Length and Successful Labor Induction: A Retrospective Cohort Study

“…Two formulae are available in Taiwan, prostin (dinoprostone vaginal tablet) and propess (dinoprostone vaginal pessary). In our previous study, propess and prostin had similar efficacy for IOL in primipara [10].…”

Predictive Factors for the Success of Vaginal Dinoprostone for the Induction of Labour

“…In addition, pregnant women in different study groups come from different races and countries, and pelvic differences and cultural differences will also lead to different pregnancy outcomes. 7 , 13 , 35 These data suggest that the probability of vaginal delivery is lower in women with complications during pregnancy. This is one of the reasons why the cesarean section rate after labor induction was higher in our study group than in other research teams.…”

“…Incorporating these factors into the management plan for cervical ripening induction can improve the quality of care and should be considered. 7 , 13 …”

“…It acts as an oxytocic. [12][13][14] Cervidil is designed to provide constant and sustained release of PGE2 to the cervix to promote cervical ripening, with the main advantage of being removable during labor or in case of adverse reactions, compared to other prostaglandins. It has been shown to be safe and effective for pregnant women and fetuses.…”

A comparative study between dinoprostone pessary and dinoprostone gel for induction of labor and neonatal outcome

“…It contains 10 mg of dinoprostone and has a sustained controlled release (0.3 mg/h) characteristic of a single application. 4 The need for repeated doses and thus the number of vaginal examinations is less when using a pessary due to its gradual release properties. 5 The pessary's knitted polyester pull-out system allows quick and easy removal when uterine tachysystole or non-reassuring FHR occurs.…”