Comparison of two forms of dinoprostone : propess and prostin for induction of labor

Abstract EN

Background: Induction of labor (IOL) aims to achieve a successful vaginal delivery.

Dinoprostone is a synthetic prostaglandin (PGE2) which works on the connective tissue stroma of the cervix and makes it favorable for normal labor.

Objective: To compare the two variants of PGE2: intra-vaginal dinoprostone vaginal suppository (Prostin E2) and 24 hours controlled-release vaginal dinoprostone pessary (Propess) for successful normal vaginal delivery.

Setting: Obstetrics and Gynecology Department, Bahrain Defence Force Hospital, Bahrain.

Design: A Retrospective Study.

Method: This study included all pregnant women who had induction of labor from January 2018 to June 2018.

A total of 322 women with a singleton pregnancy, fetal cephalic presentation and bishop score ≤4 were admitted for induction of labor.

Fifty-eight (18%) patients received 24-hours 10 mg controlled-release Propess and 264 (81.9%) received repeated doses of 2 mg Prostin E2 vaginal tablets.

Result: A high incidence of cesarean delivery in the Propess group 20/58 (34.5%) compared to 45/264 (17%) in the Prostin group was found, P-value of 0.002.

There was no difference in the incidence of hyperstimulation, need for oxytocin or fetal distress in labor.

Shorter induction-todelivery interval was obtained with Propess, 19 hours compared to 23.5 hours for Prostin E2, but the difference was not statistically significant.

Data was analyzed using StatsDirect software, P-value of less than 0.05 was considered statistically significant.

Conclusion: IOL with slow release dinoprostone is associated with increased cesarean section rate compared to Prostin.