Labor induction is used to start labour when medical or obstetric symptoms occur. Dinoprostone, a prostaglandin E2 analogue, is widely synthesised for this purpose. Dinoprostone is mostly used as gel and pessary, which have different application ways but the same active ingredient. This study examined the safety and efficacy of pessary and dinoprostone gel for labour induction, focusing on fetomaternal outcomes. A prospective randomised controlled trial included 300 healthy pregnant moms who met labor-inducing criteria. Participants were randomly assigned Pessary or Dinoprostone gels. Inducing labour was the major goal, while uterine hyperstimulation, maternal side effects, newborn Apgar scores, neonatal resuscitation, and NICU admissions were secondary endpoints. The statistical tests were used to analyse the data. Labor induction success rates for Dinoprostone gel and pessaries were 85 and 87 percent, respectively. Neither group had more maternal side effects or uterine hyperstimulation. The groups had similar infant Apgar ratings at 1 and 5 minutes, NICU admissions, and resuscitation needs. This study concludes that pessary and dinoprostone gel induce labour safely and effectively. Selecting between the two categories based on clinical indications and patient characteristics supports personalised obstetrics treatment. The findings demonstrate dinoprostone's safety and efficacy in labour induction and support clinical decision-making.
TopIntroduction
A popular obstetric procedure called labour induction is used to start or quicken labour when a medical or obstetric indication occurs, like post-term pregnancy, premature rupture of the membranes before the due date, or foetal distress (Kho et al., 2008). It is an essential tool in the management of foetal and maternal health since it enables medical professionals to step in when the onset of labour is delayed naturally or when the mother or foetus is at risk from the pregnancy continuing (Abdelaziz et al., 2018; Calder & Mackenzie, 1997).
Dinoprostone is a prostaglandin E2 analogue that is synthetic and used extensively for inducing labour because of its capacity to ripen the cervix, initiate uterine contractions, and advance labour. It is a highly useful medication in obstetric practise because it has been shown to be effective in promoting the onset and advancement of labour. Dinoprostone gel and Dinoprostone pessary are the two most widely used methods of administration. With the same active component, these two formulations provide distinct application methods (Atlas et al., 1998). The decision between these two forms is influenced by a number of variables, such as institutional protocols, patient characteristics, and clinical preference (Sanchez-Ramos et al., 1999; Hughes et al., 2001). The purpose of this research is to examine the safety and efficacy of pessary and dinoprostone gel for inducing labour, in an effort to meet the need for evidence-based clinical practise guidelines (Facchinetti et al., 2005).
Over the years, there has been much discussion and attention given to the labour induction procedure in the field of obstetrics. On the one hand, early labour can assist in avoiding maternal and foetal complications such as macrosomia, meconium aspiration syndrome, and stillbirth that are linked to longer pregnancies (ACOG committee opinion, 1999). On the other hand, in order to reduce the hazards involved with the treatment, great thought must be given to the methods employed for labour induction (Strobelt et al., 2006). Given that it ripens the cervix and induces uterine contractions, dinoprostone has become an invaluable tool in the obstetrician's toolbox (Triglia et al., 2010).
Although labour induction carries some inherent dangers, such as the requirement for a surgical birth, foetal discomfort, and uterine hyperstimulation, it can also be a life-saving surgery. To reduce these issues, clinicians must select the safest and most efficient course of action (Tempe et al., 2021). Despite the fact that dinoprostone is frequently used to induce labour, very little research has been done to directly compare the two main ways that dinoprostone is administered: gel and pessary. This knowledge gap highlights the significance of carrying out an extensive investigation that directly and rigorously assesses the safety and efficacy of these two types (Mamatha et al., 2021).
This research aims to achieve two distinct objectives:
These goals are crucial for developing the specialty of obstetrics and enhancing the care given to expectant mothers in need of induction of labour. The research's findings may influence clinical judgment, which could ultimately result in better outcomes for expectant mothers and newborns.