Induction of Labour, is the Second Propess® of any Benefit? A Comparative Study
Mohamed M. Hosni*, Hassan Morsi, Mena Abdalla, Salma Jabak, Hend Gabr and Eman Elkattan
ABSTRACT
Objectives: Induction of labour world-wide has increased dramatically over the last decade. In 2019, third of women were induced, with a rate as high as 36% for nulliparous women. Prostaglandins, and in particular, dinoprostone vaginal delivery system (Propess®) has been widely used for cervical ripening and induction of labour. However, there is no consensus on the usage of second dosage of dinoprostone for women who do not respond after 24 hours of the first dose. The aim of the current study was to determine whether placement of second Propess®, if necessary, would increase the vaginal delivery rate in
pregnant women, for whom first Propess® failed to induce cervical ripening.
Materials and Methods: This was a comparative study that included 821 women who had induction of labour by dinoprostone vaginal delivery system, at King’s College Hospitals NHS Foundation Trust, United Kingdom. We used Kolmogorov-Smirnov test to examine the distribution of the included variables, with Mann-Whitney U test used to test the differences in the continuous variables and while chi-square test and Fisher’s exact tests were used to test the differences in categorical values between the two groups.
Results: The association between placing second Propess® and obstetric outcomes showed that group who received single dose of dinoprostone was more likely to deliver vaginally.
Conclusion: Our study showed that the second dose of Propess® was associated with higher caesarean section rate and neonatal special care admission, though the difference was not statistically significant. Further multicentre randomised controlled studies with larger sample size are recommended.
