Dinoprostone – The active substance is dinoprostone, more commonly known as Prostaglandin E2. Each vaginal delivery system contains 10 mg of dinoprostone which is released at approximately 0.3 mg per hour over 24 hours.

38 Weeks – Propess is licensed to be used after 37 completed weeks gestation.

In the freezer – Store in a freezer (-10ºC to -25°C). Store in the original container in order to protect from moisture. No thawing is required prior to use.

1-3 minutes – Propess has a half-life generally estimated as 1-3 minutes.

Immediately – Propess should be removed from the freezer just prior to the insertion. No thawing is required prior to use.

No – Do not use scissors or other sharp objects which may cut the retrieval system.

As high as possible – The vaginal delivery system should be inserted high into the posterior vaginal fornix and rotated so it sits transversely behind the posterior fornix

No – No attempt should be made to tuck the end of the tape into the vagina completely always leave a reasonable amount outside as this may make retrieval more difficult otherwise.

20-30 minutes – After insertion of Propess, the patient should be recumbent for 20 minutes to 30 minutes. As dinoprostone will be released continuously over a period of 24 hours, it is important to monitor uterine contractions and fetal condition at frequent regular interval.

1. Onset of labour.
2. Spontaneous rupture of the membranes or amniotomy.
3. Evidence of fetal distress.
4. Evidence of maternal systemic adverse dinoprostone effects such as nausea, vomiting, hypotension or tachycardia.
5. At least 30 minutes prior to starting an intravenous infusion of oxytocin, as there is a much greater risk of hyperstimulation if the dinoprostone source is not ?
6. 24 hours after insertion – The vaginal delivery system should be removed after 24 hours irrespective of whether cervical ripening has been achieved.

All of the above – correct answer.