Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 14 , ISSUE 5 ( September-October, 2022 ) > List of Articles

ORIGINAL RESEARCH

Comparison between Two Preparations of Dinoprostone (PGE2)-pessary and Gel for Induction of Labor at Term

Renuka Malik, Anjali Singh, Neha Pruthi Tandon

Keywords : Dinoprostone, Inducing agents, Induction of labor, PGE2 pessary, Prostaglandin

Citation Information : Malik R, Singh A, Tandon NP. Comparison between Two Preparations of Dinoprostone (PGE2)-pessary and Gel for Induction of Labor at Term. J South Asian Feder Obs Gynae 2022; 14 (5):579-582.

DOI: 10.5005/jp-journals-10006-2104

License: CC BY-NC 4.0

Published Online: 16-11-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Background: There are multiple inducing agents available—pharmacological and non-pharmacological. The search for an ideal inducing agent continues worldwide. An ideal inducing agent should have less induction interval to delivery time, less side effects such as fetal distress and hyperstimulation, patient safety, economical, and have ease of administration. The two preparations of Dinoprostone (PGE2) gel and pessary were compared for efficacy in vaginal delivery, induction delivery interval (IDI), and cost effectiveness. Materials and methods: A prospective observational study was done in 100 patients in a tertiary level teaching hospital from 1 November 2019 to 31 March 2021. A total of 50 patients in group A received 0.5-mg PGE2 gel and 50 patients in group B had insertion of sustained release 10-mg PGE2 pessary for induction of delivery at term. The two groups were compared for the rate of vaginal delivery and IDI. Other variables, such as need of augmentation, fetal distress, postpartum haemorrhage (PPH), and neonatal intensive care unit (NICU) admission, were also compared. Results: The rate of vaginal delivery in both groups were similar. Mean induction to vaginal delivery interval was significantly lesser in the Dinoprostone pessary group (17.72 ± 6.81 hours for PGE2 pessary group vs 19.57 ± 5.46 hours for PGE2 gel group); duration of augmentation with Oxytocin was significantly lesser in the pessary group (5.68 ± 4.05 hours in pessary group vs 7.41 ± 3.44 hours in gel group). There was no significant difference in failed induction, uterine hyperstimulation, fetal distress, PPH, and NICU admission in the two groups. Conclusion: Dinoprostone gel and pessary are similar in rate of vaginal delivery. The IDI and need of oxytocin are less with PGE2 pessary. Failure rate is same for both PGE2 pessary and gel. In comparison, no marked superiority of pessary was seen over economical gel preparation.


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