Discover a new
in labor induction!
Dilapan-S® − Gentle. Predictable.
1 out of 4 pregnancies needs to be induced nowadays
Who to induce?
WHO guidelines - Inducing labor (2018)
Membrane sweeping should be offered to
nulliparas at the 40−41 week
multiparas at the 41 week
between 41+0 – 42+0 weeks
PROM, VBAC, maternal request, breech presentation,
IUGR, suspected fetal macrosomia
Implications of ARRIVE trial
Current rate of induction of labor is at the level of 25−30%, depending on territory specifics.
If ARRIVE applied into the practice, IOL rate may possibly increase up to twice!*
* prof. Gupta, J., MD. (2018, March). Recent advances in induction of labour. Lecture presented at EBCOG 2018 in France, Paris.
How to induce a labor?
Do not forget about the cervix!
In the absence of a ripe or favourable cervix, a successful vaginal birth is less likely.
Therefore, cervical ripening is mandatory before labour is intiated.
Methods of cervical ripening and Induction of labor*
- Dilapan-S® − synthetic osmotic cervical dilator
- single balloon − Foley catheter
- double balloon catheter
- membrane sweeping
- artificial rupture of membranes
- PGE1 misoprostol − vaginal or oral, in a form of pills
- PGE2 dinoprostone − vaginal or endocervical, in a form of pills, gel or pessary
- i. v. oxytocin alone
- mifepristone + misoprostol
* Please notice there are geographical variabilities with the preffered methods for the proccess of cervical ripening and labor induction
The trend of mechanical methods is rising, especially in well developed countries. Clinicians react to safety concerns – mechanical methods have minimal risk of side effects for both the expectant mother and fetus, like uterine hyperstimulation and fetal heart rate changes.
Efficacy of mechanical methods is proven to be comparable with the pharmacological methods.*
* Mechanical methods for induction of labour, Jozwiak M et al, 2012, Cochrane Systematic Review
Which attributes do clinicians see as the most important?
We can see that US clinicians find safety for mother and baby the most important, followed by efficacy of the used method.
Price of the product to the hospital was not significantly important for the most of clinicians.
Therefore mechanical methods appear to be the ideal solution.
Mechanical methods appear to be capable to solve majority of challenging situations during labor induction
Mechanical methods for labor induction
- hygroscopic synthetic cervical dilator
- made specifically for cervical dilation
- multiple rods inserted into the cervix up to 24 hours
- efficacy and safety confirmed by observational trials and the RCT DILAFOL
- certificated and used in Japan, Europe, the US and other countries recently
- suitable for low risk, high-risk groups of patients, as well as women after Cesarean section
- The only contraindication for using Dilapan-S® is clinically apparent genital tract infection
- unique combination of efficacy, safety, predictability and maternal satisfaction
- suitable product for outpatient use
- Having CE Mark and being FDA approved for induction of labor
Balloon catheters − single or double
- insertion of the balloon catheters possible up to 24 hours
- efficacy and safety confirmed by many trials
- majority of the trials done with Foley catheter
- large RCTs finished (PROBAAT I, PROBAAT II)
- outpatient cervical ripening evaluation
- Foley catheter is not FDA approved for cervical ripening