A prostaglandin for inducing labour
Dinoprostone
A prostaglandin used in hospital to ripen the cervix and induce labour.
What is Dinoprostone?
Dinoprostone is a prostaglandin given in a maternity unit as a vaginal gel, tablet or slow-release pessary to soften and open the cervix and to start (induce) labour when there is a medical reason to do so. It works by helping the cervix ripen and the womb begin to contract. The team monitors the strength of contractions and the baby's heartbeat, because contractions can sometimes become too strong. Brand names include Prostin E2 and Propess.
Education and reference only. This is a plain-language guide to Dinoprostone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Dinoprostone is a naturally occurring type of prostaglandin made up as a medicine to help start labour. It is used in hospital when labour needs to be brought on for the health of the mother or baby. Depending on the product, it is given as a gel, a tablet or a slow-release pessary placed in the vagina near the cervix. It is always used within maternity care, with monitoring.
How it works
Dinoprostone helps the cervix to soften, thin and open (ripen), and encourages the muscle of the womb to begin contracting, much as happens in natural labour. The slow-release pessary delivers the medicine gradually over a period and can be removed if needed, while the gel and tablet act over a few hours. By ripening the cervix and starting contractions, it gets labour under way when induction is needed.
Company & origin
Originated / developed by: Generic (specialist supply).
A prostaglandin used in UK maternity units to ripen the cervix and start (induce) labour.
Practical use
How to take Dinoprostone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is placed in the vagina by a midwife or doctor in hospital; you do not handle it yourself.
- Rest as advised after it is inserted, and tell staff if pains become very strong, very frequent or constant.
- The slow-release pessary can be removed by the team if contractions are too strong or when labour is established.
- You will be monitored, including checks of the baby's heartbeat, while the medicine takes effect.
- Ask for pain relief if you need it; the team can advise what suits each stage of labour.
Weighing it up
Advantages & disadvantages of Dinoprostone
Advantages
- An effective, well-established way to ripen the cervix and bring on labour when induction is needed.
- Comes in different forms, including a slow-release pessary that can be removed if necessary.
- Used with close monitoring of mother and baby in a maternity setting.
Disadvantages
- Can cause contractions that are too strong or too frequent, needing the dose to be removed or adjusted.
- May cause nausea, vomiting, diarrhoea or a raised temperature.
- Sometimes more than one application or an alternative method of induction is required.
Practical use
Good to know
Dinoprostone is only used in a maternity unit, where the midwife and obstetric team can monitor how the womb and baby respond. The main caution is that contractions can occasionally become too strong or too frequent, which is why the baby's heartbeat and the contractions are watched; if needed, a pessary can be removed and treatment adjusted. Cramping and period-like pains are expected as labour begins. Sometimes more than one application or a different method of induction is needed. The team will explain the plan, what to expect, and when to tell them about strong or constant pain. It is used with particular care in women who have had previous womb surgery, such as a caesarean, because of the strain strong contractions place on the womb.
Who should not take it / use with caution
- Women in whom a vaginal birth is not considered safe, where induction would not be appropriate.
- Women with certain previous womb surgery or particular obstetric situations, where the team will choose another approach.
- Anyone with a known allergy to prostaglandins or for whom the obstetric team judges it unsuitable.
Monitoring
- Monitoring of the baby's heartbeat and the strength and frequency of contractions.
- Regular review of progress and whether the cervix is ripening.
- Watching for over-strong contractions so the pessary can be removed or treatment adjusted.
Side effects
- Cramping and period-like pains as labour begins are expected.
- Nausea, vomiting, diarrhoea or a raised temperature can occur.
- Occasionally, contractions that are too strong or too frequent, which the team manages.
Key interactions
- It is not given at the same time as other medicines that strengthen contractions, such as oxytocin, without a careful gap, to avoid over-stimulation.
- Anti-inflammatory painkillers can blunt prostaglandin effects, so the team takes this into account.
- Tell the team about all your medicines so the induction plan can be tailored safely.
Available as: Vaginal gel, vaginal tablet and slow-release vaginal pessary used in hospital.
Answers
Dinoprostone: frequently asked questions
What is dinoprostone used for?
It is used in a maternity unit to ripen the cervix and start (induce) labour when there is a medical reason to bring labour on.
How is it given?
It is placed in the vagina by a midwife or doctor as a gel, tablet or slow-release pessary; you do not handle it yourself.
Will it hurt?
It causes cramping and period-like pains as labour begins. You can ask for pain relief, and the team will advise what suits each stage.
What if the contractions get too strong?
The team monitors contractions and the baby's heartbeat. If contractions become too strong, a pessary can be removed and treatment adjusted.
Is it the same as the drip used in labour?
No. Dinoprostone is a prostaglandin given vaginally to ripen the cervix and start labour, whereas the labour drip (oxytocin) is given into a vein to strengthen contractions later.
Authoritative sources
- BNF
- NICE CKS
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