Comparative Effectiveness of Dinoprostone Sustained-Release Vaginal Pessary and Dinoprostone Gel for Labor Induction (Code-T0271)

Aims and Objective:

Aims:  To determine the clinical efficacy and the safety of Dinoprostone sustain release vaginal pessary over Dinoprostone intracervical gel for the induction of labor.

Objective:

1. To compare maternal out come in terms of efficacy of Dinoprostone sustain release vaginal pessary and Dinoprostone gel for induction of labor.
2. To compare fetal outcome with Dinoprostone sustain release vaginal pessary and Dinoprostone gel.

Methods: In this prospective, randomized controlled trial, 80 pregnant women requiring labor induction were randomly assigned to receive either a dinoprostone sustained-release vaginal pessary (n=40) or dinoprostone gel (n=40). Primary outcomes included the time from induction to the onset of labor and the time to vaginal delivery. Secondary outcomes assessed cesarean section rates, maternal and fetal complications, and overall patient satisfaction.

Results: The mean induction-to-active labor phase time was significantly shorter in the vaginal pessary group (7.92 ± 2.45 hours) compared to the gel group (10.85 ± 2.32 hours, p < 0.001). Similarly, the mean time to vaginal delivery was shorter in the pessary group (12.98 ± 2.34 hours) than in the gel group (16.82 ± 2.57 hours, p < 0.001). Cesarean section rates were 20.00% in the pessary group and 29.00% in the gel group, though the difference was not statistically significant (p = 0.72). Maternal and fetal complication rates were comparable between the two groups, with no significant differences observed.

Conclusions: Dinoprostone sustained-release vaginal pessary is more effective than dinoprostone gel in reducing the time from induction to the active phase of labor and the overall time to vaginal delivery. Further studies are needed to validate these findings and assess long-term outcomes.

Keywords: Induction of labor, dinoprostone, vaginal pessary, intracervical gel.