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Childbirth

Propess pessary vs gel for induction - any experience?

10 replies

toomuchribbon · 18/02/2013 23:08

Does anyone have any experience on whether the Propess pessary is preferable to the Prostin gel for induction? 

I am being induced on Wednesday but am receiving conflicting information from the midwives on which is favourable and there seems to be a choice at my hospital (UCLH). After two sweeps both have said that I will probably go into labour with just a minimal dose of gel and waters being broken as I am 3cm dilated with soft mid cervix but other than that I cannot get a straight answer, beyond their instruction to ask the doctors on the labour ward when I am admitted for induction and that "much will depend on  how things are on the labour ward on the day and how busy they are" (?!). Obviously Propess can't be adjusted in dose as it's a sustained release pessary. 

I am just very keen to avoid the syntocinon drip and therefore maximise the efficacy of the gel or pessary where possible especially as it sounds like one of these may be all I need if done right!
I have seen the clinical evidence which suggests pros and cons for each but would really love to hear from anyone who has actually had either. 

Thanks so much. 

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Pleasenomorepeppa · 18/02/2013 23:19

I had DD2 at UCLH 4 weeks ago & had prostin gel.
It was done at 4pm, had 4.5 hours of period pains. At 9pm they were pretty intense. Had gas & air at 9.50pm, was 3cm & had waters broken at 10.15pm & had a baby at10.41pm.
I have nothing but praise for the MW's at UCLH. My birth experience there was wonderful.
Good luck Smile.

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IfYouCanMoveItItsNotBroken · 18/02/2013 23:36

I was induced twice with number 2. Both times it failed. But I wasn't even a centimetre, he wasn't even engaged, they therefore couldn't break my waters. The gel did bugger all, they used it first both times, but I got very strong regular contractions with propess. I was in agony within a couple hours. Propess was the second option in that hospital, after 2 rounds of gel, so I'm assuming they, as well as me, found it more effective. But if they're breaking your waters anyway you may not need the stronger option. They would have put me on the drip if they had been able to break waters, but not right away. I'm not saying this to scare you, just to explain my experience of both types! Sounds like you're ripe for the picking!(Unlike me, who eventually stormed out after a midwife told me the next step after 2 failed inductions was a csection then sheepishly came back to admit that this was the first time she had known a consultant to decide to try a third induction in 5 days, given my contractions were every 5 mins and no progress was b

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IfYouCanMoveItItsNotBroken · 18/02/2013 23:40

Sorry, I hit the button mid rant...

Being made. Long story short, my son came of his own accord 2 weeks later.

I enjoyed my rant, I hope I haven't scared you.

My sister had her waters broken and before they put gel in she was crowning. If you are in a position to have waters broken, you should be pleased.

It's late, I've made little sense.

Good luck.

My

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toomuchribbon · 19/02/2013 07:52

Pleasenomore, that's wonderful to hear, thank you - and congratulations! Was this your first DC? Apparently this can affect the decision of whether to choose prostin or propess.

Ifyoucan'tmoveit, thanks very much - that is quite an experience! Though also good to hear. I didn't know they could give both so it's strangely reassuring, if that's the right word. Your experience of particularly intense contractions with Propess echoes what others have said, too.

I have until tomorrow to decide so will keep considering...

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chocosaurus · 19/02/2013 08:08

Your less likely to need an ARM (broken waters) with propess. and also have fewer vaginal examinations.
If you start contacting with propessit can be left in until your are 4 cm before removal which should be enough to have got you going yourself and then sustain it.
In my experience women do better with propess. Your also not waiting around for the next dose if the first one does nothing. (you can't guarantee anything based on a cervical assessment).
Good luck and let us know what happens

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chocosaurus · 19/02/2013 08:12

I realise from reading my post that I didn't make very clear that avoiding arm of can is a good thing as one they're gone if you don't do anything yourself its a definite syntocinon indication which from reading your post is what your trying to avoid.

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Pleasenomorepeppa · 19/02/2013 08:54

It was no2. I had prostin gel with DD1 too. She took 4 hours! Smile

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HolidayArmadillo · 19/02/2013 08:58

At our place we use neither the gel or the propess wotsit (too expensive) and we just use prostin tablets to get the cervix open enough to do an ARM. As you're already 3cm we wouldn't bother with the prostin, we'd do the ARM and give you up to 4 hours to establish on your own before considering the syntocinon drip. Unless you're a primip, in which case we might give the prostin, though I have no idea the rationale behind that, I'd have to have a look.

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toomuchribbon · 19/02/2013 18:33

Chocosaurus, thank you, that's brilliantly helpful. I shall aim to avoid ARM.

Pleasenomore (love the name by the way!), wow that's great. Very heartening.

HolidayArmadillo, this is DC1 so yes I am a primip, so perhaps more of a candidate for the prostin or the Propess... though at UCLH they seem to give either to all. I think as much as poss I would rather choose gel/pessary than risk the synto drip.

Well, I am due to head in for induction tomorrow - having seriously cold feet as amniotic fluid level is high, placenta fine, baby active so wondering if I can wait another day... on the other hand, impatient to meet baby!

Thank you again, all xx

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chocosaurus · 23/02/2013 10:15

Any news? ?

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