Publication:

Comparative study of dinoprostone vaginal pessary versus PGE2 gel in labour induction: a randomised controlled study

Background Induction of labour is a method of prematurely or artificially stimulating the onset of labour prior to onset of spontaneous labour. Different preparations of prostaglandin are available differing in their effectiveness, side effects, and price. But the most commonly used agent for induction of labour is the shorter acting PGE2 gel. However recently the longer acting PGE2 vaginal pessary has become available. The aim of this study is to compare the efficacy of PGE2 vaginal pessary versus intracervical PGE2 gel in induction of labour.

Methods A total of 170 antenatal patients were included in the study with 85 each group. Group A was given one dose of PGE2 vaginal pessary and group B was given PGE2 gel which was repeated for maximum of 3 doses at 6 hours interval. Patients were examined for cervical ripening, uterine contractions, fetal heart monitoring and complications. Augmentation, labour duration, type of delivery, complications were all noted for both groups.

Results The 56.47% in pessary group and 40% in gel group did not need augmentation which was statistically significant (p=0.029). There was no difference in the mode of delivery between two groups.

Conclusions In my study, comparing PGE2 gel with PGE2 vaginal pessary, there was no significant difference between them in efficacy and complication. The only significant difference noted in my study was reduced need for augmentation of labour in pessary than PGE2 gel.