Tuesday, September 14, 2010



What is Cervidil?

Cervidil is the trademark name that Forest Laboratories, Inc. uses for prostaglandin E2 vaginal insert. It is a small rectangular pouch with a retrieval cord that looks similar to a tampon. It is inserted into the vagina.

Prostaglandin is one of the chemicals that play a part in ripening the cervix. A ripe cervix is soft and stretchy, ready to respond to uterine contractions. When given vaginally, cervidil may help to ripen the cervix.

Why choose Cervidil?

Cervidil is used to "ripen" the cervix when it is agreed that your baby is safer to be born than to remain in the uterus. Cervidil is the first step in a two part induction process when the cervix is not ready to respond to contractions.

Cervidil may increase the activity of non-productive contractions when no other labor stimulation agent has been used.

Cervidil allows the mother to use the medication for the prescribed amount of time an then remove it. In some cases a mother may be able to go home after administration to wait for labor to start. More often she will be admitted and the Cervidil will be administered overnight.

How effective is Cervidil?

Because prostaglandin E2 helps to make the connective tissue of the cervix more pliable while also stimulating contractions, it is more effective than synthetic oxytocin at inducing labor. The rates were similar for women giving birth within 12 hours, but more women had given birth within 24 hours with prostaglandin and the difference is even more pronounced at 48 hours. In addition, the rate of instrumental vaginal delivery is lower with women induced with prostaglandin E2.

This data sheet on Cervidil offers information from research trials about its efficacy.

Risks of using Cervidil

Risks for Mother

* Gastrointestinal effects such as nausea, vomiting and diarrhea.

* Small risk of uterine hyper stimulation.

* Requires continuous monitoring of baby's heart rate which decreases mobility.

* Another form of prostaglandin E2, Prepidil, cannot be removed if hyper stimulation occurs.

Risks for Baby

* Uterine hyper stimulation can cause abnormal fetal heart rate.

My Opinion

It's no secret that I am not a big fan of unnecessary induction. I really believe that most babies will come the exact time they are meant to and in most cases I lean towards trusting nature over science. With that said in times where induction is necessary Cervidil is a good option to get things going. I have often seen in used in conjunction with Pitocin (stay tuned for my Pitocin post). Typical administration is to inject the Cervidil and if contractions haven't started or increased to productive in 12 hours, add Pitocin. I always encourage Mom's to talk with there care providers and indpendlty research all of your options before labor and delivery begin.

Prostaglandin also occurs naturally in Seamen, and will be discussed further in my natural induction methods post.

Goer, Henci. The Thinking Woman's Guide to a Better Birth. 1999. New York: The Berkley Publishing Group.
Enkin, Keirse, Nilson, Crowther, Duley, Hodnett and Hofmeyr. A guide to effective care in pregnancy and childbirth Third Edition. 2000. Oxford: Oxford University Press.

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