DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175274

Effectiveness of dinoprostone vaginal pessary in induction of labour at term

Devdatt L. Pitale

Abstract


Background: Induction of labour is a very common obstetric procedure worldwide. The ultimate goal of induction of labour is to achieve a successful vaginal delivery. Dinoprostone is a Prostaglandin (PGE2) which acts on the collagen structural network of the cervix and makes it favourable, thus increasing the chances of a successful of a vaginal delivery. This study emphasizes on the importance of having a proper induction protocol in place and at the same time judicious use of the agents for induction of labour. This will help to reduce the maternal anxiety and stress associated with the induction of labour. The present study was undertaken to assess the effectiveness of dinoprostone vaginal pessary in induction of labour at term.

Methods: Twenty patients with unfavorable cervix at term were studied for the effectiveness of Dinoprostone vaginal pessary in induction of labor.

Results: Among the twenty patients 17 (85%) delivered vaginally within 18 hrs and 3 (15%) were in the active phase of labour. No untoward event was observed in any of the cases with a favorable neonatal outcome in all the cases.

Conclusions: Present study shows that Dinoprostone vaginal pessary is a highly effective method of induction of labor at term in properly selected cases. It reduces consistently the number of internal examinations and thus reducing the risk of ascending infections adding to it's safety along with reduced maternal anxiety associated with induction of labour.


Keywords


Dinoprostone, Induction of labour, Maternal anxiety, Vaginal pessary

Full Text:

PDF

References


American College of Obstetricians and Gynecologists. ACOG practice bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. No. 107. Induction Labor Obstet Gynecol. 2009;114:386-97.

Chauhan SP, Ananth CV. Induction of labor in the United States:a critical appraisal of appropriateness and reducibility. Semin Perinatol. 2012;36:336-43.

SOGC Clinical Practical Guideline. Induction of labour. J Obstet Gynecol Can. 2013;35(9).

National Institute for Health and Care Excellence. Induction of labour. (Clinical guideline 70). NICE, 2008. Available at www.nice.org.uk/guidance/cg70.

Tang J, Kapp N, Dragoman M, de Souza JP. WHO recommendations for misoprostol use for obstetric and gynecologic indications. Int J Gynecol Obstet. 2013;121:186-9.

Tenore JL. Methods for cervical ripening and induction of labor. Am Fam Phys. 2003;67(10):2123-8.

Jessop W. Induction of labor. Sheffield teaching Hospitals NHS Foundation trusts: November 2011. Available at http://www.sth.nhs.uk/clientfiles/File/pd5110_InductionOfLabour[1].pdf

Triglia MT, Palamara F, Lojacono A, Prefumo F, Frusca T. A randomized controlled trial of 24‐hour vaginal dinoprostone pessary compared to gel for induction of labor in term pregnancies with a Bishop score ≤4. Acta Obstetricia et Gynecologica Scandinavica. 2010 May 1;89(5):651-7.

Wing D. Techniques of cervical ripening prior to labor induction. UpToDate Online 19.1, viewed 7 April 2011. Available at http://www.uptodate.com/contents/techniques-for-cervical- ripening-prior-to-labor-induction.

Kelly AJ, Malik S, Smith L, Kavanagh J, Thomas J. Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD003101.

Mishanina E, Rogozinska E, Thatthi T, Uddin-Khan R, Khan KS, Meads C. Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis. Canadian Med Assoc J. 2014 Jun 10;186(9):665-73.

Tathem K, Harris LJ, O'rourke P, Kimble RM. Dinoprostone vaginal pessary for induction of labour: Safety of use for up to 24 h. Aust N Z J Obstet Gynecol. 2012 Dec 1;52(6):582-7.

Kho E, Sadler L, McCowan L. Induction of labour: A comparison between controlled-release dinoprostone vaginal pessary (Cervidil(r)) and dinoprostone intravaginal gel (Prostin E2(r)).Aust N Z J Obstet Gynaecol. 2008;48:473-7.

Wing DA. For the misoprostol vaginal insert consortium. misoprostol vaginal insert compared with dinoprostone vaginal insert. Obstet Gynecol. 2008;112:801-12.

Australian Council of Healthcare Standards. 2011. Available at http://www.achs.org.au/aboutus.