Explore an opportunity
to decrease staff workload, ensure requested efficacy, improve safety and maternal satisfaction with labour induction.
What your colleagues say:
“Adoption of DILAPAN-S is likely to be cost-neutral to dinoprostone vaginal insert, therefore adding this ripening agent to UK practice is not expected to increase hospital spending.”
“DILAPAN-S would be a benefit in women with reduced fetal reserve (IUGR or reduced fetal movement), as it is associated with a lower risk of uterine hyperstimulation.”
“Our trial reaffirms the better maternal satisfaction and safety profile with DILAPAN-S compared with dinoprostone, with similar overall vaginal delivery rates.”
“Outpatient cervical ripening with DILAPAN-S significantly reduced hospital stay.”
“The advantages of DILAPAN-S over Foley balloon include FDA approval, no protrusion from the introitus, no need to keep under tension and improved patient satisfaction.”
Reducing load on maternity units
Minimal complications during cervical ripening
Non-pharma mode of action brings predictability to cervical ripening and allows efficient scheduling on the labour ward
Regular CTG monitoring not required
Midwifes insertion possible
Reduction is staff time requirement by 2.4 hours vs dinoprostone
A cost-consequence analysis predicts a reduction in the birth-related staff burden, which could potentially aid in freeing up staff capacity during periods of high demand.
This was primarily due to reduced monitoring requirements when using DILAPAN-S. Moreover, DILAPAN-S was associated with a lower rate of hyperstimulation and need for strong opioid analgesics, which further decreases staff time.
Efficacy
DILAPAN-S achieves reliable first round cervical ripening success
In two clinical trials of over 500 women induced by DILAPAN-S, approximately 4 out of 5 women were ripe successfully with first round of DILAPAN-S series.
In SOLVE trial the rate was approximately by 10% higher than with dinoprostone vaginal insert.
Vaginal delivery rate comparable to prostaglandins
In five clinical trials with in total 1312 women induced by DILAPAN-S, vaginal delivery rate ranged from 63% to 81%, depending on proportion of nulliparous women and clinical protocol used.
When compared with prostaglandins, DILAPAN-S achieved similar vaginal delivery rate, while offering better safety profile and superior maternal satisfaction.
Vaginal delivery date within 24 hours comparable to low-dose oral misoprostol
DILAPAN-S may offer similar “speed of action” to complete vaginal birth as low- dose oral misoprostol. The outcome predicts that “speed of action“ is related to IOL clinical protocol rather than to the method of cervical ripening.
The use of DILAPAN-S ensures comparable efficacy to pharmacological methods while may reduce staff time requirement.
Safety
DILAPAN-S minimizes the risk of uterine tachysystole during cervical ripening
No serious adverse maternal and neonatal outcomes
| Dilapan-S | |
| Vaginal bleeding* | 3.1 % |
| Rupture of membranes* | 0.9 % |
| Tachysystole* | 0% |
| Non-reassuring fetal status* | 0.5 % |
| 5 min Apgar < 7 | 0.5 % |
| Maternal infectious co-morbidity** | 0% |
RCT DILAFOL, Saad 2019
* During cervical ripening interval
** Related to device used
Non-pharmacological cervical ripening with DILAPAN-S will help you to solve an issue of frequent uterine tachysytole and minimize risk of hyperstimulation with FHR* changes.
NICE guideline encourages discussion with women regarding risks and benefits of each method, incl. safety benefits and risks of mechanical vs pharmacological methods.
Decrease need of analgesics
Significantly less women needed analgesia during cervical ripening process in DILAPAN S group , strong opioids analgetics in particular.
Adoption of DILAPAN S can help to improve clinical outcomes, incl . reduction of using analgesia during the process of labour induction.
Maternal satisfaction
Across clinical trials comparing DILAPAN-S with dinoprostone, misoprostol and Foley catheter, more women in the DILAPAN-S group reported:
Better satisfaction as they were able to perform their daily activities
Less frequent and less intense uterine contractions
Lower pain scores during both insertion and cervical ripening
| Maternal satisfaction | Dilapan-S | Dinoprostone | |
| How much pain did you have while the drug/ device was being put in place? |
Wong Baker Pain Scale (0-10 points) |
Mean 4.3 | Mean 4.7 |
| Mean 4 | Median 4 | ||
| Were you able to perform daily activities such as walking, dressing, hygiene, shower? |
Always | 155 (76.0%) | 104 (46.9%) |
| Were you able to get some relaxing time? | Always | 108 (52.9%) | 62 (27.9%) |
| Were you able to get some sleeping time? | Always | 97 (48.0%) | 49 (22.1%) |
| Were contractions frequent? | Not at All | 73 (37.1%) | 28 (12.7%) |
| Were contractions intense? | Not at All | 87 (44.2%) | 34 (15.5%) |
| Did you feel any discomfort with the drug/ device in place? |
Not at All | 92 (46.2%) | 59 (22.7%) |
| Please rate the overall pain that you had while the drug/device was in place. |
Wong Baker Pain Scale (0-10 points) |
Mean 3.1 | Mean 5.6 |
| Median 3 | Median 6 |
RCT SOLVE, Gupta 2022
NICE IOL guideline emphasizes “maternal choice” as crucial part of decision making process and call Healthcare Professionals to discuss methods for induction of labour with expectant mothers.
Versatility
Consistent Bishop score gain across all types of induced women
All Women
Nulliparous
Multiparous
TOLAC
Solution for out-patient ripening procedure
Recently completed randomised trial confirmed that out-patient use of DILAPAN-S is effective and safe. DILAPAN-S out-patient use
- shortens significantly stay in hospital by 36% decrease in hospital stay > 48 hours
- increases vaginal delivery rate within 24 hours after admission to 70%
- offers hospital budget savings by 11% vs inpatient use
- further improves maternal satisfaction with procedure
- offers predictability; only 2.4% women in the outpatient group returned to hospital before scheduled admission time
NICE IOL guideline recommends DILAPAN-S for cervical ripening in the outpatient setting
Several clinical trials evaluated DILAPAN-S as effective and safe in labour induction of women with previous caesarean section.
DILAPAN-S is contraindicated in presence of clinically apparent genital tract infection.
Efficient and gentle cervical ripening suitable for almost all induced women.
DILAPAN-S in numbers
years of experience on the market
countries we work in
of vaginal deliveries
Consistently superior maternal satisfaction accross multiple clinical trials
Brochure for clinicians
Non-pharma cervical ripening with DILAPAN-S is perfectly suited for outpatient regimen as it does not encourage contractions and contains no pharmacological agents.
Any further information required?
