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
