What is the name of the gel for inducing labor?
Most often, specialists use Prepidil for the development of labor. The gel is injected into the cervical canal, from where it begins to actively act, provoking the production of oxytocin . The first sensations from the effects of the drug occur in the first twenty minutes. To prevent the gel from leaking, the pregnant woman remains in the gynecological chair for at least 15 minutes .
The drug is quite affordable, its average price is approximately 700 rubles . After using the medicine, leaving the medical facility is prohibited, as rapid labor may develop. They can pass in 5-10 minutes .
Tablets to prepare the cervix for childbirth
If a woman is in a maternity hospital, and the cervix is not yet mature enough, then before giving birth she is given medications that have various effects. For example, Papaverine or No-shpa are designed to eliminate spasms and relax smooth muscles. Thanks to this action, the drugs soften the cervix. This effect is the most popular and simplest in terms of stimulation.
If the situation is special and there is an option for post-maturity, and the cervix is immature, then a synthetic analogue of prostaglandin is prescribed. It prepares the cervix for childbirth.
This drug does not always lead to rapid cervical ripening; one is considered the most effective.
The dosage of the drug is 200 mg once a day. After the second appointment, a few days later the doctor evaluates the birth canal.
Why is there no dilation at 40 weeks? In order to understand this, you need to know the peculiarities of the female body and know what exactly it lacks. Only by giving the necessary elements, the uterus reaches maturity, becomes soft, opens and you can give birth. If it does not open, doctors do everything possible to do this, as evidenced by the protocol of their work. Here, pills, a Foley catheter, or other options are already used to open the birth canal. Spending 40 weeks of a successful pregnancy does not mean that your body is ready for childbirth. Foley to induce labor: what is it and what is it for?
A Foley catheter is a special medical device that looks like a tube. It is prescribed to connect natural channels and cavities and drain fluid, as well as for surgical operations.
There are several varieties of this catheter that are used to induce labor. It is the Foley catheter that can help the cervix reach maturity as soon as possible and open for childbirth.
This method cannot be called the most effective, moreover, it is painful for the woman since it is designed to place a catheter in the birth canal, after which everything is filled with air and the balloon is left for a day or until contractions begin. The end of the device is attached to the inner thigh. In order for the process to be accelerated, a catheter number 18 is used.
Inducing labor with a Foley catheter is not only painful, but also not very reliable. In addition, such a process can cause infection.
It is impossible to say for sure whether stimulation is a dangerous process, but it is prescribed exclusively by a doctor and only if it is necessary. Preparing the cervix for childbirth in the maternity hospital
In the maternity hospital, doctors’ intervention in preparing the body for childbirth does not always occur, but only if there are reasons for this.
Prepidil: indications and contraindications
The main indications for the use of Prepidil are:
- pregnancy at 42 weeks or more;
- early rupture of water without the onset of labor;
- dilation does not occur or it has slowed down very much due to the unready cervix;
- abrupt cessation of the birth process ;
- weak labor without obvious development.
But at the same time, the drug has a number of serious contraindications that should be taken into account when administering the gel .
It is not recommended to use the gel if:
- the large size of the baby’s head, which is why it cannot pass normally through the mother’s pelvis;
- the monitor shows a weak or excessively rapid fetal heartbeat;
- the child was unable to assume the correct position for natural childbirth; for such cases, only a caesarean section is indicated;
- the mother has serious problems with her kidneys and heart.
All these indications and contraindications should be taken into account when prescribing intravaginal gel . If there is at least one contraindication, it is better to give preference to a caesarean section.
Childbirth on demand: baby, it's time to go out!
You should forget about the phrases “you can’t stay pregnant forever” and “nature knows best” after 40 weeks of pregnancy.
Yes, nature has programmed the natural appearance of the baby into the world, but if this does not happen on time, you cannot meditate while waiting for it to “resolve on its own” - the “prisoner” imprisoned in the uterus may suffer from hypoxia due to the aging placenta.
In addition to the “staying” of the fetus in the uterus, there are several other reasons on the basis of which the gynecologist decides to induce labor:
- gestosis (late toxicosis of pregnancy) is a dangerous complication with a functional disorder of vital organs and systems;
- pregnancy up to 40 weeks with a complex of negative symptoms - oligohydramnios, aged placenta and poor blood biochemistry;
- disruptions during labor - fading contractions, absence of contractions when the waters break, closed or slowly opening cervix.
Is it possible to order childbirth at your own request, for example, in connection with the upcoming departure of a spouse who wants to be nearby at a sacred moment?
Hypothetically, yes, but the last word remains with the doctor, who nevertheless took the Hippocratic oath and makes decisions based on common sense.
Common sense in this case is a full-term pregnancy, full readiness of the body for childbirth and a very serious personal reason.
Most often in obstetric practice, American Prepidil gel is used to induce labor. Like all drugs in the group, this gel contains dinoprostone. It is administered intracervically through a catheter included in the kit.
Available in the form of a disposable syringe. Analogues with identical composition, indications, contraindications and side effects - Prostenon-gel, Cerviprost and Prostin E2.
By the way, Dianatal obstetric gel for childbirth is not stimulating, since it does not contain pharmaceutically active substances. Consists of propylene glycol, carbomer, hydroxyethylcellulose and water. It is distributed in the birth vaginal canal and, when applied, forms a bioadhesive film.
The target indication is to reduce friction during fetal advancement and reduce the risk of vaginal rupture.
What are other gels called?
In general, there are quite a lot of products of this type, but in our maternity hospitals only two are used - Prepidil and Prostin E2 . The second drug is injected strictly into the posterior vaginal fornix. During the procedure, the gynecologist uses a sterile syringe.
Under the influence of Prostin E2, a rapid release of oxytocin occurs. This hormone is responsible for the onset and development of the birth process. In addition, smooth muscle contraction occurs, which provokes the opening of the uterus to the desired level. The drug has a high price, which is about 2000-2500 Russian rubles .
Gel Prostin E2 shows faster results after administration, but its cost does not allow every woman in labor to use it to stimulate the labor process. At the same time, there is no big difference between the body’s final reaction to the drugs. The indications and contraindications for the drugs are also identical .
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 that 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 rare cases, this provokes nausea or vomiting in the mother.
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 the drug is taken correctly, that is, in the recommended doses for cervical ripening.
Does it hurt to insert it?
Here the opinions of the patients were divided. It all depends on the individual sensitivity and psychological mood of the woman. The procedure for administering the drug is for the most part simply unpleasant , since it is necessary to use mirrors and a syringe to carry out stimulation.
To reduce the amount of unpleasant sensations, you need to relax as much as possible.
The doctor draws out a small amount of the drug, after which, using suitable speculums, the entrance to the vagina is widened and the gel is applied. After administration, a woman may feel a slight nagging pain , which will gradually increase. To enhance the effect, it is important to remain in a horizontal position for at least half an hour.
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, uterine rupture, 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 on the Apgar scale to 7 points. Among other things, the use of the medication in question is rare, but still causes stillbirth.
How long does it take to work?
The effect of the gel, according to the instructions for the drugs, should develop within three hours . The first obvious signs of the onset of labor can be felt within 10-15 minutes . There are cases when, after 5-10 minutes, active contractions began in a pregnant woman, and the process of delivery took place in the first hour after stimulation.
Sometimes even repeated administration of the gel does not bring any results. The maximum dosage of 3 mg may not stimulate the cervix or cause contraction. In such cases, it is quite common to perform an emergency caesarean section unless the doctor decides to try the pills.
Is it possible to induce labor at home?
Many women, when approaching the 40th week, worry that there are no signs of labor in their condition.
Having consulted a doctor, they receive a recommendation to go to an inpatient department to carry out this process in artificial mode. Some women in labor prefer the option of inducing labor without the use of drugs that can have a negative impact on health - at home using light physical activity, food, and other procedures (bathing, massage).
Gymnastics
Moderate physical activity for a pregnant woman under the supervision of a doctor is a good method of inducing contractions, since movements can provoke dilatation of the uterus, which will start the process of natural delivery. Activities that are not contraindicated for women in labor include:
- walking outside (fresh air combined with movement has a beneficial effect on fetal development);
- cleaning at home (you can wash the floor not with a mop, but by hand, squatting);
- if a woman does not live on the 1st floor, climb to the required floor using the stairs in a sideways position;
- yoga has a good effect on the stimulation process by balancing breathing;
- charging in light mode using squats.
A light or moderate load on the body is encouraged; if a pregnant woman overdoes it with exercise, the birth process may be difficult and muscle tension will be present.
Foods that provoke contractions
Nutrition for an expectant mother is one of the important aspects of the well-being and harmonious development of the baby.
She must understand that the products she consumes are beneficial and do not cause harm. The following are considered products that can trigger labor:
- spicy food (it stimulates the intestines, as a result of which the uterus begins to contract and open). You need to be careful with this method and consult a gynecologist about its use (in most cases, women do not tolerate spicy food, as it causes heartburn and unpleasant taste sensations);
- tea that contains raspberry leaves or ginger pulp (not everyone can use it, it is not recommended for women in labor with special features in the structure of the pelvis, as there is a risk of rapid labor);
- pineapple pulp (it contains bromelain, which softens the uterus and prepares it for opening);
- products containing fiber (for example, seaweed) have a relaxing effect.
At home, you cannot use medications to speed up labor; such procedures are carried out only by obstetricians in a hospital setting.
Gel for intimate hygiene
In the practice of doctors, a procedure for introducing a specialized gel into the vagina is often used.
The woman in labor is seated on a gynecological chair, the vagina is filled with gel using a syringe, after which she is left lying down for 30 minutes to prevent leakage of the drug. The volume of medication that can be administered at one time does not exceed 5 mg.
Within 4-5 hours she feels mild cramping pain that spreads and gains strength. If this does not happen, the procedure can be repeated 6 hours after the first attempt. After repeated administration, there is a high probability of accelerating the process, since the concentration of stimulating substances in the body increases.
Reviews from doctors
Doctors confirm that ideally childbirth should take place naturally. But when real indications , you should trust modern medicines.
In most cases, labor begins within two hours, when it enters the active phase with contractions. But there are cases when from the moment the gel was administered and the baby was born. Sometimes, during stimulation, fetal hypoxia occurs, water is poured out, but the process does not go further, and condition of life also becomes dangerous .
That is why the drug must be administered only in a hospital setting. If necessary, specialists will be able to provide emergency assistance and give life to mother and child. Experts can never say how labor will go and how quickly it will begin.
Stages of preparing the cervix for childbirth (video)
What can be concluded? Preparing for childbirth is too subjective a concept. Gynecologists assess the readiness of the cervix only at 38 weeks, and you should not be upset if you do not hear the answer you expected. First, consult with your doctors and be sure to listen to all recommendations. Do everything that depends on you to be ready for the joyful event - the birth of your baby.
According to the degree of maturity, the cervix before childbirth can be mature, and then no measures need to be taken, as well as insufficiently mature (ripening) and immature. In the last two cases, drug preparation of the cervix for childbirth is used.
During full-term pregnancy and, especially under conditions of post-term pregnancy, it is important that the cervix is sufficiently mature, can actively open without rupture, and childbirth can take place without complications. The preparation of the cervix for childbirth occurs due to the active production of prostaglandins by the body. If they are deficient, the cervix does not reach the required degree of maturity by the time of birth, which does not give it the proper elasticity and ability to actively open.
Important
Currently, a gel for softening the cervix is considered the simplest method of stimulating labor. A gel inserted into the vagina provides an artificial prenatal hormonal balance. Such softening gels contain prostaglandins - substances that in the body of a pregnant woman begin to trigger the process of childbirth. They contribute to the smoothing and opening of the cervix. After using the product, labor can begin within four hours. The specific time of the onset of labor corresponds to the individual characteristics of the pregnant woman’s body.
For normal childbirth, dilation should reach 10 cm. Prostaglandins have been used in obstetric practice for 20 years. They have proven themselves to be highly effective drugs that imitate natural labor.
For normal birth, dilation should reach 10 cm.
Prostaglandins have been used in obstetric practice for 20 years. They have proven themselves to be highly effective drugs that imitate natural labor.
Tablets to prepare the cervix for childbirth
In a maternity hospital, if the cervix is not mature enough, special medications are administered before birth to prepare the cervix for childbirth. These drugs can have different effects - papaverine or spa to prepare the cervix for childbirth have an antispasmodic effect, relaxing smooth muscles and leading to softening of the cervix. This is one of the most popular and simplest methods of stimulation.
In special cases, when pregnancy is prone to post-term pregnancy and the cervix is still immature, the introduction of a synthetic analogue of prostaglandins - “Mifepristone”, intended to prepare the cervix for childbirth, is also indicated. The drug is prescribed in tablets at a dosage of 200 mg once a day, after the second dose of the drug, after about two to three days the condition of the birth canal is assessed. Taking this drug does not always lead to rapid ripening of the cervix.
Gels based on prostaglandins
Modern obstetrics prefers to use prostaglandin-based gels to soften the cervix. They exactly repeat the structure of active substances that are produced in the mother’s body before and during childbirth. In addition to the main effect of the gel on stimulation, it helps to quickly soften the cervix, thereby promoting the development of softer contractions without spastic components. Unlike oxytocin, prostaglandins do not disrupt uteroplacental blood flow.
Softening gels are a sterile 2.5 mg product. For insertion, the woman lies on her back and the gel is injected into the posterior vaginal fornix. The doctor constantly monitors the management process using gynecological mirrors.
It is prohibited to introduce the gel into the cervical canal - this will provoke hyperstimulation of labor. To prevent the product from leaking out, the patient should remain in a lying position for half an hour.
After administration of the gel, the patient's condition is assessed every 6 hours. If positive dynamics in the dilatation of the cervix are not evident, then the gel is injected again. The cervix should dilate by at least 3 cm within 4 hours. The maximum dosage is 3 mg.
The decision on re-introduction is made only by the attending physician after assessing the current situation.
The dose of the gel determines the desired result:
- 1 mg is administered for weak labor.
- 2 mg are administered in the complete absence of labor after a single injection.
The third time the gel is not used, and against the background of the first two applications, the patient’s well-being, contractile activity of the uterus and the condition of the child are constantly assessed.
