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CC BY-NC-ND 4.0 · AJP Rep 2018; 08(04): e307-e314
DOI: 10.1055/s-0038-1675351
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Clinical Insights for Cervical Ripening and Labor Induction Using Prostaglandins

Stephanie Pierce
1   Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Ronan Bakker
1   Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Dean A. Myers
1   Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Rodney K. Edwards
1   Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
› Author Affiliations
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Publication History

04 June 2018

11 September 2018

Publication Date:
29 October 2018 (online)

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Abstract

Cervical ripening is often the first component of labor induction and is used to facilitate the softening and thinning of the cervix in preparation for labor. Common methods used for cervical ripening include both mechanical (e.g., Foley or Cook catheters) and pharmacologic (e.g., prostaglandins) methods. The choice of method(s) for ripening should take into account the patient's medical and obstetric history, clinical characteristics, and risk of adverse effects if uterine tachysystole were to occur. In this narrative review, we highlight the differences between the prostaglandins dinoprostone and misoprostol with respect to pharmacology and pharmacokinetics, efficacy, and potential safety concerns. Practical guidance on choosing an appropriate prostaglandin agent for cervical ripening and labor induction is provided via the use of clinical vignettes. Considering the advantages and disadvantages of each preparation allows clinicians to individualize treatment, depending on the indications for induction and unique characteristics of each patient.

Keywords

prostaglandins - dinoprostone - misoprostol - cervical ripening - labor induction
 

  • References

  • 1 Osterman MJ, Martin JA. Recent declines in induction of labor by gestational age. NCHS Data Brief 2014; (155) 1-8
    PubMedGoogle Scholar
  • 2 Hamilton BE, Martin JA, Osterman MJ, Curtin SC, Matthews TJ. Births: Final Data for 2014. Natl Vital Stat Rep 2015; 64 (12) 1-64
    PubMedGoogle Scholar
  • 3 ACOG Committee on Practice Bulletins -- Obstetrics. ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol 2009; 114 (2, Pt 1): 386-397
    CrossrefPubMedGoogle Scholar
  • 4 Leppert PC. Anatomy and physiology of cervical ripening. Clin Obstet Gynecol 1995; 38 (02) 267-279
    CrossrefPubMedGoogle Scholar
  • 5 Goldberg AE. Cevical Ripening. Medscape Womens Health 2018. Available at: http://emedicine.medscape.com/article/263311-overview . Accessed October 17, 2018
    PubMedGoogle Scholar
  • 6 Alfirevic Z, Kelly AJ, Dowswell T. Intravenous oxytocin alone for cervical ripening and induction of labour. Cochrane Database Syst Rev 2009; ; (04) CD003246
    PubMedGoogle Scholar
  • 7 Wing DA, Sheibani L. Pharmacotherapy options for labor induction. Expert Opin Pharmacother 2015; 16 (11) 1657-1668
    CrossrefPubMedGoogle Scholar
  • 8 WHO recommendations for induction of labour. Available from: http://apps.who.int/iris/bitstream/handle/10665/44531/9789241501156_eng.pdf;sequence=1 ; accessed on October 6, 2018
    PubMed
  • 9 Robinson B, Nelson L. A review of the proceedings from the 2008 NICHD workshop on standardized nomenclature for cardiotocography: update on definitions, interpretative systems with management strategies, and research priorities in relation to intrapartum electronic fetal monitoring. Rev Obstet Gynecol 2008; 1 (04) 186-192
    PubMedGoogle Scholar
  • 10 Chen W, Xue J, Peprah MK. , et al. A systematic review and network meta-analysis comparing the use of Foley catheters, misoprostol, and dinoprostone for cervical ripening in the induction of labour. BJOG 2016; 123 (03) 346-354
    CrossrefPubMedGoogle Scholar
  • 11 Levine LD, Downes KL, Elovitz MA, Parry S, Sammel MD, Srinivas SK. Mechanical and pharmacologic methods of labor induction: a randomized controlled trial. Obstet Gynecol 2016; 128 (06) 1357-1364
    CrossrefPubMedGoogle Scholar
  • 12 Sciscione AC. Methods of cervical ripening and labor induction: mechanical. Clin Obstet Gynecol 2014; 57 (02) 369-376
    CrossrefPubMedGoogle Scholar
  • 13 Edwards RK, Szychowski JM, Bodea-Braescu AV, Biggio JR, Lin MG. Foley catheter for induction of labor: potential barriers to adopting the technique. J Perinatol 2015; 35 (12) 996-999
    CrossrefPubMedGoogle Scholar
  • 14 Patabendige M, Jayawardane A. Foley catheter for cervical priming in induction of labour at University Obstetrics Unit, Colombo, Sri Lanka: a clinical audit with a patient satisfaction survey. BMC Res Notes 2017; 10 (01) 155
    CrossrefPubMedGoogle Scholar
  • 15 Bakker R, Pierce S, Myers D. The role of prostaglandins E1 and E2, dinoprostone, and misoprostol in cervical ripening and the induction of labor: a mechanistic approach. Arch Gynecol Obstet 2017; 296 (02) 167-179
    CrossrefPubMedGoogle Scholar
  • 16 Stephenson ML, Wing DA. A novel misoprostol delivery system for induction of labor: clinical utility and patient considerations. Drug Des Devel Ther 2015; 9: 2321-2327
    PubMedGoogle Scholar
  • 17 Prepidil. PREPIDIL® (dinoprostone cervical gel) [package insert]. New York, NY; Pharmacia & Upjohn Company; 2017
    PubMed
  • 18 Williams MC, Tsibris JC, Davis G, Baiano J, O'brien WF. Dose variation that is associated with approximated one-quarter tablet doses of misoprostol. Am J Obstet Gynecol 2002; 187 (03) 615-619
    CrossrefPubMedGoogle Scholar
  • 19 Yount SM, Lassiter N. The pharmacology of prostaglandins for induction of labor. J Midwifery Womens Health 2013; 58 (02) 133-144 , quiz 238–239
    CrossrefPubMedGoogle Scholar
  • 20 Blesson CS, Sahlin L. Prostaglandin E and F receptors in the uterus. Receptors Clin Investig 2014; 1: e115
    PubMedGoogle Scholar
  • 21 Breyer RM, Bagdassarian CK, Myers SA, Breyer MD. Prostanoid receptors: subtypes and signaling. Annu Rev Pharmacol Toxicol 2001; 41: 661-690
    CrossrefPubMedGoogle Scholar
  • 22 Sooranna SR, Grigsby P, Myatt L, Bennett PR, Johnson MR. Prostanoid receptors in human uterine myocytes: the effect of reproductive state and stretch. Mol Hum Reprod 2005; 11 (12) 859-864
    CrossrefPubMedGoogle Scholar
  • 23 CERVIDIL. . CERVIDIL® (dinoprostone vaginal insert) [package insert]. Parsippany, NJ; Ferring Pharmaceuticals Inc; 2016
    PubMed
  • 24 Church S, Van Meter A, Whitfield R. Dinoprostone compared with misoprostol for cervical ripening for induction of labor at term. J Midwifery Womens Health 2009; 54 (05) 405-411
    CrossrefPubMedGoogle Scholar
  • 25 Facchinetti F, Fontanesi F, Del Giovane C. Pre-induction of labour: comparing dinoprostone vaginal insert to repeated prostaglandin administration: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2012; 25 (10) 1965-1969
    CrossrefPubMedGoogle Scholar
  • 26 Cytotec. Cytotec® (misoprostol oral tablets) [package insert]. New York, NY; G.D. Searle Inc; 2016
    PubMed
  • 27 Zieman M, Fong SK, Benowitz NL, Banskter D, Darney PD. Absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol 1997; 90 (01) 88-92
    CrossrefPubMedGoogle Scholar
  • 28 Lyons C, Beharry K, Akmal Y, Attenello F, Nageotte MP. In vitro response of prostaglandin E2 receptor (EP3) in the term pregnant rat uterus and cervix to misoprostol. Prostaglandins Other Lipid Mediat 2003; 70 (3,4): 317-329
    CrossrefPubMedGoogle Scholar
  • 29 Chioss G, Costantine MM, Bytautiene E. , et al. In vitro myometrial contractility profiles of different pharmacological agents used for induction of labor. Am J Perinatol 2012; 29 (09) 699-704
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Chiossi G, Costantine MM, Bytautiene E. , et al. The effects of prostaglandin E1 and prostaglandin E2 on in vitro myometrial contractility and uterine structure. Am J Perinatol 2012; 29 (08) 615-622
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Rugarn O, Tipping D, Powers B, Wing DA. Induction of labour with retrievable prostaglandin vaginal inserts: outcomes following retrieval due to an intrapartum adverse event. BJOG 2017; 124 (05) 796-803
    CrossrefPubMedGoogle Scholar
  • 32 Hofmeyr GJ, Gülmezoglu AM, Pileggi C. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database Syst Rev 2010; ; (10) CD000941
    PubMedGoogle Scholar
  • 33 Rouse DJ. The misoprostol vaginal insert: déjà vu all over again. Obstet Gynecol 2013; 122 (2, Pt 1): 193-194
    CrossrefPubMedGoogle Scholar
  • 34 Grobman WA, Rice MM, Reddy UM. , et al. Labor induction versus expectant management in low-risk nulliparous women. N Engl J Med 2018; 379 (06) 513-23
    CrossrefPubMedGoogle Scholar
  • 35 Ozkan S, Calişkan E, Doğer E, Yücesoy I, Ozeren S, Vural B. Comparative efficacy and safety of vaginal misoprostol versus dinoprostone vaginal insert in labor induction at term: a randomized trial. Arch Gynecol Obstet 2009; 280 (01) 19-24
    CrossrefPubMedGoogle Scholar
  • 36 Ramsey PS, Meyer L, Walkes BA. , et al. Cardiotocographic abnormalities associated with dinoprostone and misoprostol cervical ripening. Obstet Gynecol 2005; 105 (01) 85-90
    CrossrefPubMedGoogle Scholar
  • 37 Wing DA, Brown R, Plante LA, Miller H, Rugarn O, Powers BL. Misoprostol vaginal insert and time to vaginal delivery: a randomized controlled trial. Obstet Gynecol 2013; 122 (2, Pt 1): 201-209
    CrossrefPubMedGoogle Scholar
  • 38 Mayer RB, Oppelt P, Shebl O, Pömer J, Allerstorfer C, Weiss C. Initial clinical experience with a misoprostol vaginal insert in comparison with a dinoprostone insert for inducing labor. Eur J Obstet Gynecol Reprod Biol 2016; 200: 89-93
    CrossrefPubMedGoogle Scholar
  • 39 Heuser CC, Knight S, Esplin MS. , et al. Tachysystole in term labor: incidence, risk factors, outcomes, and effect on fetal heart tracings. Am J Obstet Gynecol 2013; 209 (01) 32.e1-32.e6
    CrossrefPubMedGoogle Scholar
  • 40 Byun YJ, Kim HS, Yang JI, Kim JH, Kim HY, Chang SJ. Umbilical artery Doppler study as a predictive marker of perinatal outcome in preterm small for gestational age infants. Yonsei Med J 2009; 50 (01) 39-44
    CrossrefPubMedGoogle Scholar
  • 41 Bruner JB, Levy DW, Arger PH. Doppler ultrasonography of the umbilical cord in complicated pregnancies. South Med J 1993; 86 (04) 418-422
    CrossrefPubMedGoogle Scholar
  • 42 American College of Obstetricians and Gynecologists Committee on Obstetric Practice. ACOG committee opinion no. 342: induction of labor for vaginal birth after cesarean delivery. Obstet Gynecol 2006; 108 (02) 465-468
    CrossrefPubMedGoogle Scholar
  • 43 ACOG Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin no. 188: prelabor rupture of membranes. Obstet Gynecol 2018; 131 (01) e1-e14
    CrossrefPubMedGoogle Scholar
  • 44 Hannah ME, Ohlsson A, Farine D. , et al; TERMPROM Study Group. Induction of labor compared with expectant management for prelabor rupture of the membranes at term. N Engl J Med 1996; 334 (16) 1005-1010
    CrossrefPubMedGoogle Scholar
  • 45 Mackeen AD, Durie DE, Lin M. , et al. Foley plus oxytocin compared with oxytocin for induction after membrane rupture: a randomized controlled trial. Obstet Gynecol 2018; 131 (01) 4-11
    CrossrefPubMedGoogle Scholar
  • 46 Word RA, Li XH, Hnat M, Carrick K. Dynamics of cervical remodeling during pregnancy and parturition: mechanisms and current concepts. Semin Reprod Med 2007; 25 (01) 69-79
    Article in Thieme ConnectPubMedGoogle Scholar
  • 47 Alfirevic Z, Aflaifel N, Weeks A. Oral misoprostol for induction of labour. Cochrane Database Syst Rev 2014; ; (06) CD001338
    PubMedGoogle Scholar
  • 48 Liu A, Lv J, Hu Y, Lang J, Ma L, Chen W. Efficacy and safety of intravaginal misoprostol versus intracervical dinoprostone for labor induction at term: a systematic review and meta-analysis. J Obstet Gynaecol Res 2014; 40 (04) 897-906
    CrossrefPubMedGoogle Scholar
  • 49 Nadia Bennett K, Park H, Cioffi J, Calixte R, Vintzileos A. A comparison of obstetrical outcomes and costs between misoprostol and dinoprostone for induction of labor. J Matern Fetal Neonatal Med 2016; 29 (22) 3732-3736
    CrossrefPubMedGoogle Scholar