Clinical Outcome of Dinoprostone Vaginal Pessary and Dinoprostone Intracervical Gel on Induction of Labor: An Observational Study

Abstract

Abstract Background: Labor induction is a common and essential procedure in obstetrics. Various new formulations of prostaglandins are currently being used for labor induction. Trials are being conducted regularly using new formulations to see the efficacy and outcome of labor induction. Materials and Methods: Prospective observational study was conducted to compare the clinical outcome of dinoprostone pessary (DP) and intracervical dinoprostone gel (DG) on induction of labor. The objectives were to study the efficacy on induction-to-delivery duration, to compare the time taken from application to initiation of labor, and the number of applications required. The study also compared the need for oxytocin augmentation, cesarean rate, and neonatal outcomes after delivery. Results: In the DP group, 86.7% of patients required single application and 68.4% of patients in the DG group required double application. In 91.6% of patients in the DG group and 68.3% of patients in the DP group labor were initiated in <12 h. About 11.7% in the DP group and 6.7% of patients in the DG group required more than 24 h for labor initiation. Requirement of oxytocin augmentation was less in the DP group compared to the DG group (48.3% vs. 53.3%). Requirement of cesarean delivery was 40% in the DP group and 26.7% in the DG group, and the difference was not statistically significant. Ninety percentage among DP groups and 100% in DG groups were having clear liquor. No patient in either group delivered neonate with Appearance, Pulse, Grimace, Activity, Respiration (APGAR) <7 at 1 min and <9 in 5 min or required neonatal intensive care unit (NICU) admission. Conclusion: In patients with similar demographic and obstetric profiles, DG had a faster induction-to-delivery time. DG had faster initiation of labor within 12 h. There was no significant difference in the requirement of augmentation with oxytocin in either group. Delivery outcomes such as cesarean rate, meconium-stained liquor, neonatal APGAR, and NICU admission were comparable in both groups.