Patient selection (see Table 5)

Using a small amount of water-miscible lubricant, place the tab into the posterior fornix of the cervix. As the device absorbs moisture and swells, it releases dinoprostone at a rate of 0.3 mg per hour for 12 hours.

Monitor fetal heart rate and uterine activity continuously, starting 15 to 30 minutes before introduction of the insert. Because hyperstimulation may occur up to nine and one-half hours after placement of the insert, fetal heart rate and uterine activity should be monitored from placement of the insert until 15 minutes after it is removed.

After insertion, the patient should remain recumbent for two hours.

Remove the insert by pulling the cord after 12 hours, when active labor begins, or if uterine hyperstimulation occurs.