Propess versus Prostin: There is an alternative way to induce labour

Abstract

Background Following a shortage of Prostin gel in 2015, an alternative method of inducing labour was required. The Propess® pessary was sourced, a guideline adapted for local use and the method introduced into the local unit. There was a perception that this means of induction took longer than the traditional Prostin but with a higher vaginal birth rate. Aims To evaluate the effectiveness and safety of Propess® as a method of induction compared with Prostin. Methods A retrospective audit to compare the labour and mode of birth of all women who were induced in the Directorate over a specific time period. The NICE Clinical Guideline no. 70 (2008) was used as the audit standard. Findings Only 28.5% women in the Propess® group required the use of oxytocin to artificially initiate contractions, versus 43% in the Prostin group. The Prostin group took slightly longer overall from the start of the induction process to the birth of the baby. There was a similar vaginal birth rate in both groups and similar clinical outcomes for the babies. Conclusions Propess® is a safe, effective means to induce labour with its use to be continued locally. Results have been disseminated within the wider hospital group and a new audit planned for 2017.