Propess - Ferring Healthcare Professional

About Propess

Propess is a single application, removable, controlled-release vaginal delivery system containing 10mg dinoprostone which is a prostaglandin E2. It is indicated for the initiation of cervical ripening in women from 38 weeks gestation as part of the induction of labour process.¹

When Propess is inserted into the vagina, dinoprostone is released at a mean rate of approximately 0.3 mg/hour and drug release continues as long as the product is in situ in the vagina (for a period of up to 24 hours). The system is equipped with a withdrawal tape that facilitates convenient and easy removal when active labour begins or removal of the system is indicated.¹

Propess was launched in the UK in 1995 and has since become one of the leading products in managing induction of labour, with over 12 million prescriptions dispensed globally between 1995 and 2017 ²

Propess Key Messages

Single Intervention

a. Simple administration technique¹

b. May reduce number of vaginal examinations (when compared with multiple dose interventions)³

c. One Propess insert treats for up to 24 hours¹

Control

a. Constant release of prostaglandin at approximately 0.3mg per hour for up to 24 hours¹

b. The product can be removed quickly and easily¹

Acceptability

a. Women’s experience of Propess insert in situ – 88% were unaware of its presence intravaginally whilst 9% who were aware felt no discomfort⁵

b. High degree of acceptability by both women and clinicians⁴

Efficacy

a. Efficacy of Propess is similar to other PGE₂ preparations⁶

b. Reduction in the use of oxytocin augmentation with Propess compared with PGE2 gel (23.3% versus 41.3%; RR 0.55, 95% CI 0.35 to 0.88; two RCTs)⁷

Safety

a. Well tolerated in achieving cervical ripening and labour in both nulliparous and multiparous women⁴

b. 3 year follow up: no adverse consequences on child health or development⁸

c. Can be used with caution in women presenting with PROM (should be removed if membranes rupture while Propess is in place). Since the release of dinoprostone from the insert can be affected by the presence of amniotic fluid, special attention should be given to uterine activity and fetal condition¹

Learn More

Training & Resources

FAQs

Ferring Pharmaceuticals. Propess Summary of Product Characteristics. October 2021 https://www.medicines.org.uk/emc/product/135 last viewed on 18/10/21
Ferring Data on File 2019.
R K Kallkat, E McMillan and H Cooper, Comparison of Dinoprostone slow release pessary (Propess) with gel (Prostin) for induction of labour at term-a randomised trial, Journal of Obstetrics and Gynaecology (2008)
Calder AA and MacKenzie I, Review of Propess – a controlled release dinoprostone (prostaglandin E2) pessary, Journal of Obstetrics and Gynaecology (1997), Vol 17, Supplement 2, S53-S67
Westgate J & Williams J.A. Evaluation of a controlled release vaginal prostaglandin E2 pessary with a retrieval system for the induction of labour, Journal of Obstetrics and Gynaecology (1994), Vol 14, Issue 3 May, 146-150
Kelly AJ, Malik S, Smith L, Kavanagh J, Thomas J. Vaginal prostaglandin (PGE2 and PGF2a) for induction of labour at term. Cochrane Database of Systematic Reviews 2014, http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003101.pub3/abstract; (last viewed 18/10/21)
Induction of Labour: 2021 Update, National Collaborating Centre for Women’s and Children’s Health, available at https://www.nice.org.uk/guidance/cg70/evidence/full-guideline-pdf-241871149 (last viewed 18/10/21)
MacKenzie I and McKinlay E (1995). Paediatric follow-up study: Follow-up of infants delivered by spontaneous vaginal delivery, following prostaglandin E2 or oxytocin induction by caesarean section, In: Propess RS – A Clinical Review, edited by Calder A, Keirse M and Mackenzie I, pp. 37–39. Euromed Communications Ltd. England.

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