Natural childbirth - “Gel stimulation, birth and puncture of the amniotic sac.” What is a gel to induce labor and how does it work?

Why is a drug such as Prepidil (gel) used? Reviews about the effectiveness of the medication, as well as the indications for this remedy, will be described below. We will also provide information on how the drug mentioned should be used, how much it costs and what its principle of action is.

Description, packaging and composition

In what packaging is the drug "Prepidil" produced? Intracervical gel goes on sale in polyethylene disposable syringes complete with a catheter. They are placed in blister packs and cardboard boxes, respectively.

Translucent and viscous drug"Prepidil" (gel) contains the active ingredient dinoprostone. Colloidal anhydrous silicon dioxide and triacetylglycerol are added as auxiliary substances.

Mechanism of action

What is the drug "Prepidil"? During childbirth, the gel stimulates the ripening of the cervix. Its active substance is an unsaturated fatty acid, which is synthesized under physiological conditions.

The specific principle of action of the drug when used intracervically has not been studied. However, experts believe that dinoprostone is able to increase blood supply to the cervix, thereby accelerating its maturation (softening, smoothing and opening). Such actions are fully consistent with normal labor changes, which lead to a decrease in cervical resistance and an increase in myometrial contraction, as well as to delivery.

It should also be noted that the active element of the drug in question can also have a stimulating effect on the muscles of the gastrointestinal tract. IN in rare cases this provokes nausea or vomiting in the woman in labor.

In high dosages, dinoprostone can lower blood pressure (due to the effect on the smooth muscles of blood vessels and capillaries), as well as increase body temperature. However, it should be noted that all these effects are not observed when correct intake drug, that is, in recommended doses for cervical ripening.

Kinetics

What kinetic parameters are inherent in the drug "Prepidil"? The gel, the price of which is indicated below, after intracervical administration in an amount of 500 mcg reaches its maximum concentration in the blood after 35-45 minutes. After this content active substance quickly decreases to the initial level (regardless of contractile activity uterus).

Dinoprostone binds 73% to human albumin. Wherein active ingredient the drug is distributed throughout all tissues and biological fluids the mother's body.

Dinoprostone is metabolized to a large extent in the lungs, as well as in the kidneys and liver. At least nine metabolites of prostaglandin E2 are found in human urine and blood.

Most of active substance"Prepidil" is excreted through the kidneys, and in small quantities - along with feces.

Indications

Why is the medication “Prepidil” needed? The gel helps stimulate cervical ripening. It is used only if there are indications for labor activity.

Contraindications

The gel is not used for conditions for which prolonged uterine contractions are contraindicated. These include:

• multiple pregnancy;
• lack of insertion of the fetal head;
• from 6 full-term pregnancies;
• traumatic or difficult childbirth (including a history);
• surgical interventions on the uterus or cesarean section (including in history);
• discrepancy between the sizes of the mother's pelvis and the fetal head;
• fetal distress (antecedent);
• a situation in which surgical intervention preferable;
• disturbances in the rhythm of fetal heart contractions;
• bloody discharge from the genital tract during pregnancy (of unknown origin);
• infections of the genital tract (lower sections);
• abnormal;
• hypersensitivity to the ingredients of the gel.

The remedy in question is used with caution when arterial hypertension, cardiovascular diseases, liver dysfunction, bronchial asthma, impaired kidney function, opened amniotic sac, ocular hypertension or glaucoma.

The drug "Prepidil" (gel): instructions

The entire contents of the syringe are used as the initial dosage, using the included catheter. It is introduced into cervical canal, which is located below the level of the internal pharynx.

As soon as the gel is introduced, the woman in labor should lie on her back for ¼ hour. This is necessary in order to minimize the leakage of the drug.

If stimulation does not occur at the initial dose of the drug, then the drug is administered again (after 6 hours). The dose for repeated administration of the drug remains the same.

The need for additional use of the gel is determined based on the clinical situation.

Maximum daily dosage of the medication in question is 1.5 mg.

Mode of application

How should I use the gel to induce labor? The instructions contain the following step-by-step actions:

Adverse reactions

What side effects can the drug Prepidil cause? The gel in a woman in labor can provoke titanic contractions of the uterus (an increase in its tone, frequency and duration of contractions), as well as nausea, vomiting, back pain, diarrhea, increased body temperature, hypersensitivity reactions and a feeling of warmth in the vagina.

In the fetus, this drug can cause the development of distress syndrome, as well as change the heart rate, reducing the assessment of the newborn’s condition by up to 7 points. Among other things, the use of the medication in question is rare, but still causes stillbirth.

The drug "Prepidil" (gel): reviews and price

The cost of this product is quite high. One syringe with gel can be purchased for 580-650 rubles. It should be noted that this drug should only be used in a hospital setting.

Doctors say that to use Prepidil, you should first assess the correspondence of the woman’s pelvis and the size of the fetal head. If they do not correspond to each other, then the medicine is not used.

According to patients, the remedy in question can cause a huge amount of side effects, including those dangerous to the life of a child. Therefore, most of them refuse to use this gel, especially after reaching the age of 35.

The due date prescribed by the doctor has long passed, but the baby still doesn’t want to be born. Of course, there is little pleasant in this situation, but you understand perfectly well that in such situations you simply cannot do without stimulation.

Typically, labor should begin at 38-40 weeks of pregnancy, but unfortunately, this does not always happen. If your pregnancy is prolonged, you should definitely consult a doctor. In this situation, doctors are forced to resort to induction of labor.

The fact that a pregnancy is post-term is influenced by many indicators, most of which cannot be prevented. These may be violations nervous system, obesity or problems with the endocrine system.

Also, some doctors believe that the woman’s age can affect post-term pregnancy. More often, such cases of post-term pregnancy are known after 30 years. But no matter what affects the post-term pregnancy, one thing has been proven for sure: it harms the child and therefore stimulation will be simply necessary.

Causes of prolonged pregnancies

They resort to induction of labor not only during post-term pregnancy, but also during weak labor, when contractions are too weak and, as a result, the cervix does not open, or cannot open completely.

There are several ways to stimulate pregnancy:

• intravenous administration of oxytocin, a drug that stimulates contractions;
• puncture amniotic sac;
• introduction of hormones that cause contractions;
• using gel to stimulate contractions.

How does labor induction gel work?

Gel for inducing labor is the safest and effective method stimulate labor. The main components of the gel to stimulate labor are prostaglandin hormones, they smooth the cervix and open it.

At normal birth The cervix should dilate 10 centimeters. This is a very important parameter so that the baby can be born without injuring the mother and himself.

Prostaglandin hormones have been used in obstetrics for 20 years, and their effectiveness has been proven by researchers and tested in practice by obstetricians.

To stimulate labor, a woman is given oxytocin intravenously; the advantage of prostaglandins is that these hormones provoke the release of oxytocin in a woman.

Oxytocin is responsible for contractions of the smooth muscles of the uterus. Prostaglandins also help reduce pain during contractions. This hormone also does not interfere with fetal and uterine-placental blood flow.

Used in obstetrics vaginal gel prostin E2, this gel is inserted using a syringe into the vagina to back wall. The process of introducing the labor gel is observed using a mirror. To prevent the gel from leaking, it is administered to women in a lying position, and after administration, the patient must remain in this position for another 30 minutes.

The gel should not be injected into the cervical canal, as this may provoke hyperventilation of labor.

After the administration of the gel, the woman is under close medical supervision. If the cervix does not dilate by 3 cm within 6 hours, this drug must be re-administered.

Dosage this drug should not exceed 3 milligrams. For weak labor, the dosage of the gel is 1 milligram every 6 hours. Doctors monitor labor and the woman’s condition.

Stimulation of labor using a gel must be carried out under the close supervision of doctors. The gel does not provide side effects at correct use.

The gel for inducing labor has shown itself to be good. This tool The best way stimulation of labor, according to the testimony of obstetricians and women to whom it was administered. The use of the gel does not affect the fetus, since it is administered into the vagina and not intravenously.

• a disruption in labor is obvious;
• there are no contractions, but the amniotic fluid has already receded;
• no cervical dilatation;
• contractions last a long time for a long time due to the fact that labor is irregular and very weak.

In some cases, fetal hypoxia, aspiration syndrome and many other problems may develop. This has become the reason that they try to use labor stimulation only in extreme cases. And sometimes stimulation is prohibited as it is whole line contraindications: the baby’s head is too large, and the mother’s pelvis is too narrow; Using a heart monitor, it was discovered that the baby was not feeling well; the position of the baby in the uterus does not correspond to the norms; there are big problems with the health of the mother in labor.

All these factors, which may affect whether labor will be induced or not, should initially be taken into account by the doctor and very carefully monitor how labor progresses.

At the same time, it is very important that the woman does not get nervous. After all, this will be reflected not only on her general condition health and well-being, but also on the child. Therefore, it is better to tune in to a positive wave, and shift all worries about your labor activity onto the shoulders of specialists who will take care of you and your baby in at its best.

And while the doctors are deciding whether to perform stimulation or not, just calm down and imagine your meeting with the little happiness that will very soon lie in your arms. Try to feel all this joy and positive emotions and then you won’t even notice how the contractions will pass and the birth will end!

The due date prescribed by the doctor has long passed, but the baby still doesn’t want to be born. Of course, there is little pleasant in this situation, but you understand perfectly well that in such situations you simply cannot do without stimulation.

Typically, labor should begin at 38-40 weeks of pregnancy, but unfortunately, this does not always happen. If your pregnancy is prolonged, you should definitely consult a doctor. In this situation, doctors are forced to resort to induction of labor.

The fact that a pregnancy is post-term is influenced by many indicators, most of which cannot be prevented. These could be disorders of the nervous system, obesity or problems with the endocrine system.

Also, some doctors believe that the woman’s age can affect post-term pregnancy. More often, such cases of post-term pregnancy are known after 30 years. But no matter what affects the post-term pregnancy, one thing has been proven for sure: it harms the child and therefore stimulation will be simply necessary.

Causes of prolonged pregnancies

They resort to induction of labor not only during post-term pregnancy, but also during weak labor, when contractions are too weak and, as a result, the cervix does not open, or cannot open completely.

There are several ways to stimulate pregnancy:

• intravenous administration of oxytocin, a drug that stimulates contractions;
• puncture of the amniotic sac;
• introduction of hormones that cause contractions;
• using gel to stimulate contractions.

How does labor induction gel work?

Labor induction gel is the safest and most effective way to induce labor. The main components of the gel to stimulate labor are prostaglandin hormones, they smooth the cervix and open it.

During a normal birth, the cervix should dilate 10 centimeters. This is a very important parameter so that the baby can be born without injuring the mother and himself.

Prostaglandin hormones have been used in obstetrics for 20 years, and their effectiveness has been proven by researchers and tested in practice by obstetricians.

To stimulate labor, a woman is given oxytocin intravenously; the advantage of prostaglandins is that these hormones provoke the release of oxytocin in a woman.

Oxytocin is responsible for contractions of the smooth muscles of the uterus. Prostaglandins also help reduce pain during contractions. This hormone also does not interfere with fetal and uterine-placental blood flow.

In obstetrics, vaginal gel Prostin E2 is used; this gel is injected with a syringe into the vagina to the back wall. The process of introducing the labor gel is observed using a mirror. To prevent the gel from leaking, it is administered to women in a lying position, and after administration, the patient must remain in this position for another 30 minutes.

The gel should not be injected into the cervical canal, as this may provoke hyperventilation of labor.

After the administration of the gel, the woman is under close medical supervision. If the cervix does not dilate by 3 cm within 6 hours, this drug must be re-administered.

The dosage of this drug should not exceed 3 milligrams. For weak labor, the dosage of the gel is 1 milligram every 6 hours. Doctors monitor labor and the woman’s condition.

Stimulation of labor using a gel must be carried out under the close supervision of doctors. The gel has no side effects when used correctly.

The gel for inducing labor has shown itself to be good. This remedy is the best way to induce labor, according to the indications of obstetricians and women to whom it was administered. The use of the gel does not affect the fetus, since it is administered into the vagina and not intravenously.

• a disruption in labor is obvious;
• there are no contractions, but the amniotic fluid has already receded;
• no cervical dilatation;
• contractions last for a very long time due to the fact that labor is irregular and very weak.

In some cases, fetal hypoxia, aspiration syndrome and many other problems may develop. This has become the reason that they try to use induction of labor only in extreme cases. And sometimes stimulation is prohibited because there are a number of contraindications: the baby’s head is too large, and the mother’s pelvis is too narrow; Using a heart monitor, it was discovered that the baby was not feeling well; the position of the baby in the uterus does not correspond to the norms; there are big problems with the health of the mother in labor.

All these factors, which may affect whether labor will be induced or not, should initially be taken into account by the doctor and very carefully monitor how labor progresses.

At the same time, it is very important that the woman does not get nervous. After all, this will affect not only her general health and well-being, but also the child. Therefore, it is better to tune in to a positive wave, and shift all worries about your labor activity onto the shoulders of specialists who will take care of you and your baby in the best possible way.

And while the doctors are deciding whether to perform stimulation or not, just calm down and imagine your meeting with the little happiness that will very soon lie in your arms. Try to feel all this joy and positive emotions and then you won’t even notice how the contractions will pass and the birth will end!

Gel for inducing labor today is the softest and most modern way stimulation of labor. Gel stimulation is the most safe way induce labor and is used very widely.

In most cases, labor begins on its own, however, some pregnant women various reasons carry the baby to term. The due date approaches, but it still doesn’t begin.

In order for labor to begin, the mother's body must undergo major changes. For example, the cervix ripens, it softens, shortens and opens slightly. Prostaglandins, which are produced in the mother’s body and in the child’s body, play a huge role in the process of preparing the body for childbirth. If few of them are produced, labor is inhibited and the pregnancy is delayed. That is why the administration of the same aspirin to a pregnant woman in the third trimester can cause it - it disrupts the production of prostaglandins.

Doctors use synthetic prostaglandins in obstetric practice for more than 20 years, And stimulation of labor with gel has also been used in our country for more than a decade. There is a huge amount of experience, and there is no need to be afraid of the gel for inducing labor.

It is clear that in order to induce labor, there must be indications. Just like that, because they are tired of being pregnant, they will not induce labor, because any stimulation is fraught with danger for both mother and baby.

Gel stimulation is carried out:

Gel for inducing labor (the name of the most common drug is Prostin E2) contains prostaglandins E2, synthetic analogue naturally occurring prostaglandins. It is inserted into the posterior vaginal fornix, which starts the process natural birth. The pain during childbirth caused in this way is less, the cervix quickly softens and opens, the onset of labor can be within 40 minutes - 4 hours from the introduction of the stimulation gel.

Reviews about such births are mostly positive. It’s also good for the child, labor essentially develops on its own and proceeds as if without stimulation, which means that the blood flow between mother and fetus does not suffer.

Prostin E2 is used only in maternity hospitals. This drug is available in disposable syringes containing 2.5 ml of gel for vaginal administration. Stimulation of labor with gel is carried out as follows: On the pregnant woman’s gynecological chair, the gel is injected from a syringe into the posterior fornix of the vagina (not into the cervix, this is dangerous), and she is asked to lie quietly for 20-30 minutes so that the gel does not leak out. As a rule, contractions appear very soon, and for many they are quite intense right away.

After 6 hours there should be a dilation of 3 cm; if this is not the case, the gel is reintroduced. Induction of labor requires careful attitude to the fetus and constant monitoring of its condition to avoid intrauterine hypoxia. The activity of contractions is also monitored. As a rule, if the indications are taken into account and the gel is injected into the right dose, there are no complications during childbirth, no side effects.

Stimulation of labor with gel has contraindications. It cannot be carried out if there is

Every woman awaits the birth of her baby with excitement and trepidation. Sometimes this process is delayed, and specialists are forced to use a gel to stimulate labor so that the baby is born sooner. This remedy is considered the most effective and safe.

Why do you need a gel to stimulate labor?

By the end of the 9th month, sufficient changes had occurred in the body of the expectant mother. For labor to begin, the cervix must ripen, soften, become shorter and open slightly. In some cases, this process does not start on its own. Then the obstetricians resort to special drugs to induce labor, helping to open the cervix.

Indications for induction of labor:

• At 43 weeks of pregnancy;
• Weak activity of the reproductive organs;
• Increased arterial pressure;
• Pathological kidney disease;
• Discharge of amniotic fluid without continuation of contractions;
• Emergency permission for pathological condition fetus

There are several methods of childbirth. This is puncture of the amniotic sac, injection of the drug “Oxytocin”, which provokes contractions. But most safe method Doctors consider stimulating labor with the help of gels and suppositories.

The gel contains prostaglandins, which prepare and open the cervix. After administration, contractions can begin within an hour, so the procedure is carried out only in a hospital.

Childbirth caused in this way proceeds as usual, but the pain is much less, since the drug softens the uterus well.

"Prostin" or "Prepidil": gel for inducing labor

Prostaglandin gels have advantages over other means of accelerating the resolution process. They are absolutely harmless to the baby and do not hinder movement, while IVs force the woman to lie on her back, complicating childbirth. The procedure has no side effects and contraindications. Childbirth takes place naturally.

Such means include:

• "Prepidil";
• "Sorry."

"Prepidil" and "Prostin E2" are gels intended for vaginal administration only. The drugs are injected using a syringe into the cervical canal of the uterus, below the internal os. The procedure is carried out on a gynecological chair and monitored using a mirror. After administering the medicine, the woman needs to lie down for some time so that the medicine does not leak out.

If within 6 hours the uterus has not dilated by 3 cm, the drug is re-administered to speed up contractions. The total dose is 3 mg. For normal labor, the cervix should dilate 10 cm.

"Prostin E2" is also available in tablets. Increases the tone of the uterus, promotes its maturation and birth process. The tablet contains 0.5 mg. dinoprostone for single use.

Instructions for use contain contraindications.

Stimulants should not be used under the following conditions:

• Narrow pelvis of a woman in labor, fetal head larger size pelvis;
• Critical condition of the fetus;
• Incorrect positioning of the child;
• Indications for caesarean section, maternal health, age.

When used correctly and good specialist side effects can be avoided.

A woman should know: how to induce labor

The introduction of the gel is necessary to soften and open the cervix. When using it, doctors synchronize 2 actions: maturation and stimulation of contractions.

Before using the drug, the doctor assesses the condition of the cervix, the location of the fetus, and measures the mother’s pulse and blood pressure.

Before administration, the gel is warmed in natural conditions to room temperature. After the procedure, a specialist observes the woman in labor every 2 hours. As a rule, the maturation of the uterus is accompanied by natural labor.

Expectant mothers are often concerned about the question: how long will it take to induce labor? In most cases, the first changes begin within 3 hours. The uterus shortens and becomes mature in 85 percent of women. After a few hours, spontaneous labor begins.

If the drug is administered, but there is no effect, a repeat dose is given, which is monitored by the attending physician.

During the process of stimulation, the uterus begins to contract; the procedure is natural and does not have any negative influence for the fruit

Advantages of using gels:

• Quick stimulating effect to prepare for childbirth;
• Reduces the risk of protracted labor;
• The amount of gel is injected as much as the uterus is dilated;
• The calling gel does not have any effect side effect to the fruit;
• The medicine does not cause an increase in blood pressure;
• It has the same effect in post-term pregnancy, hypertension, and in women with renal failure.

For a long time clinical practice vaginal gel has proven itself with the best side. The components that open the uterus, in most cases, lead to natural delivery.

Medical reviews on induction of labor

Many people care about a doctor's assessment of a particular medicine. Almost all experts have a positive attitude towards the use of stimulating gels. Although side effects are noted.

Disadvantages of using the drug:

• Hypertonicity of the uterus;
• In some cases, headaches and chills;
• The patients complained of nausea and gastrointestinal disorders;
• Disorders of the circulatory system.

And yet, experts often use stimulant gels, considering them the safest means.