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The aim of this study is to evaluate the efficiency of dinoprostone insert, compared with dinoprostone gel, for cervical ripening and induction of labor in women at term. We searched electronic databases and bibliographies of relevant papers to identify randomized controlled trials (RCTs) reporting dinoprostone insert and gel used for cervical ripening and induction of labor. Fifteen RCTs involving 1779 women were included. Dinoprostone insert could greatly contribute to vaginal delivery (VD) within 24 h compared with dinoprostone gel (OR = 2.35, 95% CI = 1.34, 4.13) and the researchers found obvious statistically significant difference (p = 0.003). Yet a meta-analysis of the rates of VD, artificial assisted vaginal delivery and caesarean section (CS) revealed no margin between dinoprostone insert and gel. Dinoprostone insert showed a distinct superiority in terms of VD within 24 h and had an advantage of a shorter hospital stay and less postpartum hemorrhage in contrast to gel. Even though the insert did not perform much better than gel in decreasing the rate of CS and increasing the rate of VD, yet the superior benefit of the vaginal insert compared to gel was still not difficult to observe.

drug discoveries and therapeutics

Efficiency of dinoprostone insert for cervical ripening and induction of labor in women of full-term pregnancy compared with dinoprostone gel: A meta-analysis