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  • Snapshot
    • A 30-year-old G1P0 patient presents to the labor and delivery floor at 37 weeks of pregnancy. She has been experiencing contractions for 5 hours and has had premature rupture of membranes. Upon vaginal exam, her cervix is only 1 cm dilated, 10% effacement, and firm cervical consistency. The decision is made to administer a cervical ripening agent to optimize vaginal delivery.
  • Introduction
    • Drugs
      • dinoprostone
        • vaginal suppository
    • Mechanism of action
      • prostaglandin E2 (PGE2)
        • causes increased uterine tone and relaxed cervical smooth muscle
    • Clinical use
      • cervical ripening
      • pregnancy termination
    • Adverse effects
      • abnormal uterine contractions
      • gastrointestinal upset
      • rarely, uterine rupture
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