Evaluation of patients' satisfaction of cervical ripening using dinoprostone by either intravaginal gel or pessary: an open-label, randomized, prospective study.

OBJECTIVE: To evaluate patient satisfaction of cervical ripening using dinoprostone (PGE2) by either intravaginal gel or pessary. STUDY DESIGN: A group of 173 nulliparous women requiring cervical ripening were recruited in the study and randomized to receive either intravaginal gel (Prepidil, Upjohn, Milan, Italy [group A]) or intravaginal pessary (Propess, Ferring Pharmaceuticals, Malmö, Sweden [group B]). Before administration of PGE2 and after delivery, the patients answered a questionnaire investigating the anxiety and discomfort caused by cervical ripening. RESULTS: Of the group, 22 women did not adequately complete the questionnaire; therefore 151 women were included in the study. Before cervical ripening, anxiety and discomfort did not significantly differ between the two study groups; more patients in group A than in group B declared they would have preferred the other form of application. The intensity of pain experienced during the application of PGE2 was higher in group B than in group A. For the future opportunity to choose the application necessary for cervical ripening, more patients in group B than in group A would change the form of application. CONCLUSION: Patient satisfaction with the two forms of treatment appears to be equally good. The application of the intravaginal pessary causes more discomfort than the vaginal gel.