Effectiveness and outcome of Dinoprostone (Propess®) for cervical ripping: A retrospective study

Background: There are different pharmacological and mechanical types of cervical dilators have been approved to ripen unfavorable cervix. The dinoprostone slow release Prostaglandin E2 (PGE2) (Propess®) is available as vaginal pessary for cervical ripening, which releases 10 mg of dinoprostone over 24 hours. The effect of PGE2 has been investigated and there are many studies in the literature comparing the efficacy of the different formulations available in the market. In our study, we evaluated PGE2 slow release on ripping cervix on different patient varieties and we evaluated the maternal outcome secondary to induction of labor by (Propess®). Material and methods: This retrospective Cohort study included 187 patients whom were induced for labor at term with intact amniotic membrane from first of January till 31 December 2018. The induction was by (Propess®). Result: The Propess® was effective on ripping cervix within 24 hours with high response rate 77.9% on Para (P) ≤2. The Propess® was effective on cervical ripping in 71% of normal body mass index (BMI) and show less response on high BMI. No increased risk of caesarean section on patients with different amniotic fluid index. The vaginal delivery rate was 81.1% of the normal amniotic fluid index, 88.2% of oligohydramnios patients. We had 82.1%of intrauterine fetal growth restriction patients achieved vaginal delivery. Conclusion: The Propess® is an effective method for cervical ripening, but less effective on high parity and high body mass index. No increase of fetal distress and caesarean section on oligohydramnios or intrauterine growth restriction in compare to normal fetus. *Correspondence to: Hanifah Bukhari, Maternal and Fetal Medicine Fellow, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia, E-mail: dr.hanifah@hotmail.com