Can you tell me more about how my doctor might induce labor with the use of prostaglandins?
The expert answers
There are two main ways labor is induced with prostaglandins:
Dinoprostone (Cervidil): This is a form of prostaglandin (PGE2) in a 10 mg, slow-release form. The medication is placed within the tip of a string resembling a shoelace. This is inserted into the vagina, adjacent to the cervix, and typically left there for 12 hours. The prostaglandin is released at a rate of 0.3 milligram per hour. If hyperstimulation occurs, medical personnel can easily remove it by pulling out the string.
PGE2 Suppositories or Gel (Prepidil): Prostaglandin suppositories can be inserted and placed either beside or into the cervix. The pharmacy can use these suppositories to make a prostaglandin gel that can be smeared on the cervix. Unfortunately, the suppository first must be melted so it can be added to other ingredients, denaturing the prostaglandin and rendering it less effective. Typically, a commercially prepared product, Prepidil, is used instead. Each dose provides 0.5 milligram of PGE2 for application. Doses can be repeated every six hours until ripening is sufficient or labor begins.
These methods can result in hyperstimulation (hypertonus) of the uterus. For this reason, hospitalization and close fetal monitoring are mandatory.
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