The Clinical Observation Of Controlled-release Dinoprostone Vaginal Suppository (Propess) For Labor Induction In Term Pregnancy And Cervical Ripening.

Purpose :To explore the efficacy and safety of Controlled-release dinoprostone vaginal suppository(Propess)for labor induction in term pregnancy and cervical ripening.Methods:140 cases of puerperae who had nomal laboured were chosen form China-Japan union Hospital of Jilin University between January 2009 and February 2011. All the cases were divided into dinoprostone group (experimental group,70 cases),nomal labour without drug group (control group,70 cases). The experimental group (70 cases )received a propess pessary inserted into vaginal for cervical ripening and abor induction in term pregnancy. No significant differences were found in average age,gestational weeks,the cervical Bishop score and Estimated fetal weight between the two groups (P>0.05). Then we show the observation projects as follows:the age,gravida and parity, gestational weeks,the cervical Bishop score,complications during pregnancy,EFW, fetal heart rate monitoring,time lapses from drug application to uterine contraction, contractions situation,time of the dilatation of cervix, descending of fetal head, the cervical Bishop score(when we take out the dinoprostone), treatment duration, adverse reaction, dilivery method, postpartum hemorrhage,the time of labour(it contains the first,the second and the third stage of labor),FHR, neonatal Apgar score, MSAF.T test andχ2 test are used for statistical analysis. There was singnificant difference between two groups if P<0.05.A retrospective hospital-based case-control study was conducted to prove the superiority and necessary of using dinoprostone vaginal suppository in clinical work.Results:Statistical results, time of the dilatation of cervix in experimental group was 6.47±2.51h,which is shorter than in control group(9.43±3.92h).There was significant difference between two groups(P<0.05).The postpartum hemorrhage in experimental group(77.14±25.27ml) was significant less than in control group. The difference was significant(P<0.05). The time of labour(405.00±149.99min),the first(363.20±147.34min) and the second stage of labour(31.92±15.29min) was significant shorter than in control group(P<0.05). The third stage of labour was 5.52±1.94min in experimental group,while it was 6.57±2.85min in control group.There were no significant differences between two groups(P﹥0.05). No significant differences were found in the latent phase of the first stage of labour ,while the active phase in experimental group was shorter than in the control group(P<0.05). No significant differences were found in anomalous FHR, neonatal Apgar score and MSAF between two groups(P﹥0.05).The rate of anomalous descending of fetal head in experimental group was obviously lower compared with the control group(P<0.05). Time lapses from drug application to uterine contraction in experimental group is 3.35±1.81h.The average time of using dinoprostone vaginal suppository is 9.58±2.38h.The major side effect of propess was uterine hyperstimulation,which would disappear after we take out of the drug. In our study,this side effect occurred in 4 cases. There are the other two kinds of side effect occured in our study.They are hyperpyrexia and incoordinated uterine inertia,which can disappear after we taking out of this Controlled-release dinoprostone vaginal suppositor(yPropess).Experimental group (70 cases) received a propess inserted into vaginal for cerval ripening. According to the change of the cervical Bishop score to estimate the effect of cervical ripening. It was excellence in 80 cases , effective in 5 cases. The rate of cesarean section in experimental group(16.67%) was markedly reduced compared with the control group(32.10%)(P<0.05).Conclusion:1, The effect of controlled-release dinoprostone vaginal suppository(Propess)for cervical ripening is obvious. It can not only improve the cervical Bishop score effectively,but also can shorten the time of cervical ripening. The effect of Propess is closely linked to the cervical Bishop score.While it isn't directly related to the time of drug application.Therefore,it is quite clear that Propess can offer commendable precondition.2, The time of labour,the first and the second stage of labour was shorten significantly by Propess.What is more,the time of labour pains could be shorten sharply.Thus, dinoprostone would increase the confidence of vaginal delivery.At the same time,it could be accepted and approved by hundreds of millions of gravidae and their families.3, The rate of anomalous descending of fetal head could be obviously reduced by Propess. In this way,the time of labour can be shorten.4,It is so dependable and safe for fetal/neonatal that it may cause nothing serious in anomalous FHR, neonatal Apgar score and MSAF.5,Our study shows that dinoprostone is efficient in achieving cervical ripening and successful vaginal delivery with negligible maternal and fetal/neonatal side effects.6,In conclusion, Propess can be used for labour induction and cervical ripening safely and effectively in our clinical work. And, this kind of vaginal suppository is so convenience that it can be easily accepted by gravidae.Doctors should choose different and reasonable dilivery methods to different gravidae.Furthermore,all of us medical staff should formulate much more rational and humanized projects,in order to serve the people and society.