Induction of labour at term with vaginal prostaglandins preparations: A randomised controlled trial of Prostin vs Propess

Abstract

The purpose of the trial was to determine whether a sustained release preparation of prostaglandin E2 (Propess) is better in inducing labour when compared with the more widely used short-acting (instant-release) preparation (Prostin). A randomised controlled clinical trial involving 100 pregnant women at term with an indication for induction of labour was conducted in a district general hospital in the UK over a 1-year period. Women were randomised to receive one of the two preparations. The study revealed that there was no statistically significant difference in time to onset of labour, duration of labour, total time from induction to delivery, method of delivery, and analgesia requirements. The number of preparations required to induce labour were significantly less in the Propess group. Our data suggest that both Propess and Prostin are safe and effective in induction of labour, for either primips or multips. However, Prostin use is more cost-effective.

A prospective randomized comparative study of the efficacy of sustained release vaginal insert versus intracervical gel in primigravidae at term pregnancy

“…In the present study no pregnant women delivered neonate with Apgar <7 at 5 min in both groups and this was consistent with the findings of Vollebregt et al, Strobelt et al and El-shawarby et al [22][23][24] In vaginal insert group 14% neonates required NICU admission for more than 24 hours in this study whereas in gel group 12% required NICU admission for >24 hours. In a study by Rugarn O et al, only 3.7% of neonates had NICU admissions with vaginal insert.…”

Outcome of Induction of Labour in Nulliparous Women Following Replacement of Cervidil with Prostin

“…This was not observed by others [5] who however, used a different proprietary long-acting retrievable preparation. An earlier larger but similar retrospective cohort study [4] had noted that nulliparous women induced with the longer acting preparation had significantly longer median insertion to vaginal birth interval.…”

“…Recently longer-acting Dinoprostone preparations (Cervidil and Propess) with retrieval system have become available which have been successfully used for IOL. Nevertheless, some studies [4] show that longer-acting preparations do not reduce time to delivery or improve any birth outcome compared to the shorter acting gel which is also considered more cost effective [5]. It has been noted [3] that more than one dose of the long acting preparation is needed to achieve amniotomy compared to the shorter acting one.…”

Induction of labor and pain: a randomized trial between two vaginal preparations of dinoprostone in nulliparous women with an unfavorable cervix

“…Lack of consensus likely depends on the heterogeneous characteristics of the control group in terms of parity, gestational age, pre-induction Bishop score, substance and dosage used. In earlier studies, the pessary has been indifferently compared with vaginal or intracervical gel containing prostaglandin E 2 , and with misoprostol, a strong analog which has multiple indications [9][10][11][12][13][14][15][16][17]; more recently equal effectiveness has been reported for both procedures [18,19].…”