Pre-induction cervical ripening using two different dinoprostone vaginal preparations: A randomized clinical trial of tablets and slow release retrievable insert

Objective: The current study compared the safety and efficacy of two different dinoprostone preparations (dinoprostone vaginal tablets & dinoprostone slow release retrievable vaginal insert) to ripen the cervix at term. Materials and methods: Women admitted for pre-induction cervical ripening were included in a randomized controlled trial. Eligible women were randomly assigned to receive Dinoprostone either in the form of vaginal tablets or slow release retrievable vaginal insert. Study outcomes included time to vaginal delivery and time to onset of labor intervals and vaginal delivery rate. Results: No statistically significant difference was found between the two groups regarding the main outcome measures, however, the probability of successful vaginal delivery was independently related to the type of dinoprostone preparation used to ripen the cervix (proportional hazard, 1.366; 95% CI, 1.010-1.847; P, 0.043) and the parity (proportional hazard, 1.412; 95% CI, 1.041-1.915; P, 0.026). Conclusion: Both dinoprostone preparations were effective and potentially safe. The probability of successful vaginal delivery was higher with dinoprostone vaginal tablets while use of dinoprostone vaginal insert was associated with better patients' acceptability. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.