Dinoproston

Dinoprostone, also known as prostaglandin E2, is a medication that mimics the actions of the naturally occurring prostaglandin E2 in the body. It is used clinically to prepare the cervix for labor (cervical ripening) and to induce labor in pregnant individuals at or near term. It is typically administered vaginally in several formulations, including a gel, a controlled‑release vaginal insert, or vaginal suppositories.

Mechanism of action and effects: Dinoprostone acts on prostanoid receptors in the cervix and uterus, promoting cervical remodeling and uterine contractions. This combination facilitates softening and dilation of the cervix and progression of labor.

Administration and dosing: Dosing is formulation‑dependent. Gel is applied into the vaginal fornix, the insert sits in the vagina to release prostaglandin over time, and suppositories provide a local dose. After administration, continuous monitoring of contractions and fetal heart rate is recommended due to the risk of tachysystole or fetal distress. Onset of action can occur within minutes to hours, and the insert may release prostaglandin for up to about 12 hours.

Safety, contraindications, and side effects: Common adverse effects include fever, chills, nausea, vomiting, diarrhea, headache, and vaginal bleeding. Serious risks include uterine tachysystole and uterine rupture, particularly in individuals with certain obstetric histories or contraindications. Dinoprostone should be avoided in those with hypersensitivity to prostaglandins or in conditions where induction is not appropriate.

Availability and regulation: Dinoprostone is marketed under several brand names, such as Cervidil and Prepidil, and is used under medical supervision with maternal and fetal monitoring.