Uses

Dinoprostone (prostaglandin E2) is indicated for cervical ripening in pregnant women at or near term with a medical or obstetrical need for labor induction. It prepares the cervix for induction by promoting softening, effacement, and dilation.

Do not use if

Prior uterine surgery or cesarean section; cephalopelvic disproportion; non-vertex presentation; unexplained vaginal bleeding during current pregnancy; active genital herpes; concurrent oxytocin use. Contraindicated when vaginal delivery is not advised or when fetal distress is noted.

Side effects

Uterine hyperstimulation or hypertonus (abnormal contraction pattern), fetal heart rate abnormalities, gastrointestinal effects (nausea, vomiting, diarrhea), back pain, and fever. Amniotic fluid embolism is a rare but serious complication.

Warnings

For hospital use only. Must be administered by trained obstetric personnel with immediate access to intensive care and surgical facilities. Continuous fetal monitoring is required. Risk of uterine hyperstimulation; remove gel/insert immediately if abnormal uterine activity or fetal distress occurs. Do not use concurrently with oxytocin.

How it works

Dinoprostone is a naturally occurring prostaglandin E2 that acts on specific prostaglandin receptors in the uterine myometrium and cervix. It stimulates myometrial contractions and promotes cervical effacement and dilation by increasing collagenase activity and altering glycosaminoglycan composition of the cervical stroma. It also stimulates gastrointestinal smooth muscle.

Storage

Store under continuous refrigeration at 2°C–8°C (36°F–46°F). Do not freeze. Use within the period indicated on packaging once removed from refrigerator.