Dinoprostone Pessary for Cervical Ripening and Labor Induction

Critical Cardiovascular Contraindications

The European Society of Cardiology warns that dinoprostone is absolutely contraindicated in women with active cardiovascular disease due to its profound effects on blood pressure, with a theoretical risk of coronary vasospasm and a low but real risk of arrhythmias 1, 2
Mechanical methods such as Foley catheter are preferable to dinoprostone in patients with cyanotic heart disease, where drops in systemic vascular resistance or blood pressure would be detrimental 1, 2
Dinoprostone is contraindicated in women with severe cardiovascular conditions, including active cardiovascular disease, severe aortic stenosis, pulmonary hypertension, or cyanotic heart disease 1, 2

Oral misoprostol results in fewer cesarean sections compared to vaginal dinoprostone, with a relative risk of 0.84, and has significantly lower costs 3
Dinoprostone requires refrigeration, while misoprostol is stable at room temperature, making misoprostol more practical in resource-limited settings 3