24-Hour Vaginal Dinoprostone Pessary Versus Gel for Labour Induction
Status:
Completed
Trial end date:
2008-06-01
Target enrollment:
Participant gender:
Summary
The aim of induction of labour is to initiate labour when maternal and fetal conditions
necessitate delivery before the onset of spontaneous contractions. Prostaglandins are widely
used for induction of labour, and can be administered orally, vaginally, intracervically,
endovenously and by extra-amniotic or intra-amniotic routes. Dinoprostone is one of the
synthetic prostaglandins most commonly used to achieve cervical ripening and labour
induction, and can be administered as tablets, suppositories, gel (vaginal and intracervical)
or as a controlled-release intravaginal pessary. The controlled-release pessary has some
potential advantages: a single application is required; the insert is easily administered and
can be removed as soon as labour starts or if complications ensue. Studies comparing the
dinoprostone vaginal insert to other prostaglandin formulations have shown variable results,
probably influenced by drug administration regimens, indications for induction, and cervical
conditions of the women. The purpose of this study is to assess the efficacy of the induction
of labour using dinoprostone in patients with an unfavourable cervix, and to compare the
efficacy and the cost of 24-hours controlled-release dinoprostone pessary and intravaginal
dinoprostone gel.