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Prostaglandin E 2 (PGE 2) achieves cervical ripening and softening by stimulating uterine contractions as well as directly acting on the collagenase present in the cervix to soften it. [7] There are currently two formulations of PGE 2 analog available for use in cervical ripening: Prepidil, a vaginal gel, and Cervidil, a vaginal insert. [24]
Concern has been raised that uterine hyperstimulation that occurs during a misoprostol-induced labor is more difficult to treat than hyperstimulation during labors induced by other drugs. [58] Because the complications are rare, it is difficult to determine if misoprostol causes a higher risk than do other cervical ripening agents.
Cervical ripening using dinoprostone vaginal inserts have the same rates of neonatal morbidity, caesarean section, and labor onset when used in the outpatient setting and the inpatient setting. [20] Evidence for use of misoprostol in the outpatient versus inpatient setting was insufficient to draw conclusions.
Cook Medical Double Balloon known as the Cervical Ripening Balloon with Stylet for assisted placement is FDA approved. The Double balloon provides one balloon to be inflated with saline on one side of the Uterine side of the cervix and the second balloon to be inflated with saline on the vaginal side of the cervix.
Osteoporosis, including drug- and cancer-related osteoporosis, giant cell tumour of bone and hypercalcaemia of malignancies: Hypercholesterolaemia, cataract, urinary retention, hypocalcaemia, osteonecrosis of the jaw and anaphylaxis. Gemtuzumab ozogamicin: IV: CD33 antibody that induces apoptosis of the tagged cell. Acute myeloid leukaemia
Use of mifepristone as a cervical ripening agent has been described. [169] The medication has been studied as an antiandrogen in the treatment of prostate cancer . [ 170 ] [ 171 ] Mifepristone showed no detectable anti-HIV activity in clinical trials.
Types of Uterotonic drugs with pertinent drug information adapted from Obstetric Anesthesiology. [6] Utertonic Administration Onset Duration of Action Common Side Effects Contraindications Oxytocin: IV Bolus IV continuous infusion Intramuscularly (IM) IV: < 1 min IM: 3-5 min IV: 20 min IM: 30-90 min IV: Hypotension, tachycardia, arrhythmia
ATC code G02 Other gynecologicals is a therapeutic subgroup of the Anatomical Therapeutic Chemical Classification System, a system of alphanumeric codes developed by the World Health Organization (WHO) for the classification of drugs and other medical products.