Most of the time, nature decides when labor begins. But in some cases, including when there are health issues that affect you or your baby, your doctor might recommend inducing labor. If your cervix -- the barrier between the uterus and vagina -- isn't ready for labor yet, he might suggest using Cervidil. Cervidil is the brand name for dinoprostone, a medication often used as the first step in labor induction. While the drug has benefits, it also has risks.
In the last few weeks of pregnancy, the cervix normally becomes soft and pliable and also thins out. This "ripening" enables the cervix to open more easily once labor begins. If the cervix isn't ripe, it won't dilate as easily. Cervidil is a synthetic form of prostaglandin E2, a chemical messenger produced in the uterus that initiates uterine contractions. Cervidil helps soften and thin the cervix so it dilates more easily during the induction of labor.
What to Expect
A member of your health care team usually inserts Cervidil -- which comes in a thin gel packaged to release gradually over a 12-hour period -- the night before they plan to start an intravenous infusion of oxytocin (Pitocin) to start the uterus contracting. If your doctor suggests this, you will probably stay in the hospital overnight, in case of complications from the Cervidil. Because the insert has a string attached, your doctor can remove it from the vagina if you have contractions that are too strong or frequent. The most common side effect is uterine hyperstimulation, or exceptionally strong or frequent contractions, occurring in less than 5 percent of women in clinical studies. Fewer than 1 percent experienced fever, nausea, vomiting, abdominal pain or diarrhea, the second most common set of side effects, from the drug.
When Problems Arise
When contractions occur too close together, the uterine muscle doesn't have enough time to relax. This can affect oxygen delivery to your baby. In 5 to 7 percent of cases in clinical trials, Cervidil caused fetal distress, normally evidenced by changes in the unborn baby's heart rate. Removing Cervidil resulted in a return to a normal heartbeat in between 2 to 13 minutes, Drugs.com reports. The other serious complication from Cervidil -- uterine rupture from too-strong or too frequent uterine contractions -- has occurred in rare incidences. If this happens, the baby could die and you could require an immediate hysterectomy to save your life.
Contraindications for Cervidil
Some women should not receive Cervidil. Contraindications for the drug include having given birth to 6 or more children; previous Cesarean delivery or other uterine surgery that could make uterine rupture more likely; an allergy to prostaglandins; or unexplained vaginal bleeding during pregnancy. Known contraindications to vaginal delivery -- such as an active herpes infection, placenta previa or an abnormal fetal position -- also preclude use of Cervidil.