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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]
Labor induction is the process or treatment that stimulates childbirth and delivery. Inducing (starting) labor can be accomplished with pharmaceutical or non-pharmaceutical methods. In Western countries, it is estimated that one-quarter of pregnant women have their labor medically induced with drug treatment. [1]
Cervical consistency and position are scored from 0 to 2. The total score ranges with a minimum of 0 and maximum of 13. A Bishop score of 6 and below indicates that induction is not favorable and no method of induction will be highly effective. In these cases, cervical ripening agents may be used.
Misoprostol is a synthetic prostaglandin medication used to prevent and treat stomach and duodenal ulcers, induce labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus. [10] [11] It is taken by mouth when used to prevent gastric ulcers in people taking nonsteroidal anti-inflammatory drugs (NSAID). [11]
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. [51] [55] [172] [173]
Adequate cervical preparation is important prior to surgical abortions because it helps to prevent complications of dilation and evacuation (D&E), such as laceration of the cervix. [5] Cervical preparation can be accomplished with osmotic dilators, with medications such as prostaglandins and/or mifepristone, or with a combination of these.
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A uterotonic, also known as an oxytocic or ecbolic, is a type of medication used to induce contraction or greater tonicity of the uterus. Uterotonics are used both to induce labor and to reduce postpartum hemorrhage. [1] Labor induction in the third trimester of pregnancy may be required due to medical necessity, or may be desired for social ...