Uterine hyperstimulation following cervix ripening with dinoprostone in a vaginal insert system
Brouwers, J.M.M.; Briët, J.W.; Brouwers, J.R.B.J.
Nederlands Tijdschrift Voor Geneeskunde 148(26): 1300-1303
2004
ISSN/ISBN: 0028-2162 PMID: 15279216 Document Number: 580344
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.