[Uterine hyperstimulation following cervix ripening with dinoprostone in a vaginal insert system].
Three women, aged 28, 29 and 31 years, primigravidae, with an unripe cervix and an indication for induction of labour, were administered dinoprostone in a controlled vaginal insert system (VIS). A few hours after the insertion of the VIS strong, prolonged contractions occurred with bradycardia in the foetus, resulting in an emergency caesarean section. The children and the mothers recovered well. A potential adverse drug reaction of prostaglandins is uterine hyperstimulation. The sustained-release intravaginal dinoprostone was expected to be safer than the intravaginal or intracervical application of a prostaglandin gel. But data from the literature are conflicting. The risk of uterine hyperstimulation by prostaglandins including the sustained-release dinoprostone system necessitates a re-evaluation of the indications for induction of labour and the procedures of cervical priming. Up-to-date guidelines are an essential tool for the safe use of prostaglandins in daily obstetric practice.
Rijksuniversiteit Groningen, Gebouw 3126, Bloemsingel 1, 9713 BZ Groningen. j.r.b.j.brouwers@farm.rug.nl
J M M
JM
Brouwers
J W
JW
Briët
J R B J
JR
Brouwers
D000282:Administration, Intravaginal; D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects; D002584:Cervix Uteri / Q000187:drug effects* / Q000502:physiology*; D002585:Cesarean Section; D003692:Delayed-Action Preparations / Q000009:adverse effects; D036861:Delivery, Obstetric / Q000379:methods; D015232:Dinoprostone / Q000008:administration & dosage* / Q000009:adverse effects; D004630:Emergencies; D005260:Female; D005782:Gels; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D013997:Time Factors; D014590:Uterine Contraction / Q000187:drug effects
D003692:Delayed-Action Preparations; D005782:Gels; D010120:Oxytocics; D015232:Dinoprostone