Clinical observation of Propess used in promoting cervical ripening and induced labor of term pregnancy

Objective:To evaluate the efficacy and safety of intravaginal prostaglandin E2 (PGE2) pessary (propess) for cervical ripening.Methods:Tow hundred and thirty one who had Bishop score of 5 or less,carried singleton pregnancies in cephalic presentation and had reached a gestational age of at least 37 weeks,without severe medical diseases were scheduled to undergo indicated of labor. Study group received a propess pessary insert into vaginal for cervical ripening,while control group received transvenous administered sodium prasterone sulfate of 200 mg per day. The Bishop score of cervical,the contraction of the uterus,the time interval from induction to delivery,delivery method,postpartum hemorrhage rate and the fetal and neonate condition were compared.Results:Six and twelve hours after administration,Bishop score in study group were added 6.5±2.2 and 7.9±1.8,they were higher than those in the control group,4.3±1.9 and 4.9±1.2,the difference was significant (P0.01). The onset of labor occurred in 24 hours in 81.1% (112/138) of the study group,which was significantly higher than that in control group (P0.01),in which 8.8% (8/93) occurred active labor. The rate of delivery in study group was 66.2% (91/138) and in control group was 31.6%,the difference was significant (P0.05). The meantime to vaginal delivery in study group was (20.86±17.23)h,was significant shorter than that in control group (79.32±51.65)h (P0.05). No significant difference were found in amniotic fluid,fetal distress or neonatal Apgar scores,postpartum hemorrhage rate between the two groups (P0.05). The major side-effect was overstimulation of uterine contraction.Conclusion:Propess is affective in producing cervical ripening,shorten labor time,increasing the rate of vaginal delivery,and can be used safely in clinic.