"Prepidil-gel" to stimulate childbirth: reviews and consequences
Pregnancy is an important stage in the life of every woman. Sometimes for one reason or another it is required to stimulate the generic process by medical means. Quite often for this purpose the drug "Prepidil-gel" is used. Of course, patients who are faced with the need to use this medication are interested in any available information. Is it safe to treat the product? What is known about contraindications and adverse reactions?
Information about the form of release and the composition of the drug
In modern obstetric practice, the drug “Prepidil-gel” is often used. This drug is intended for vaginal or intracervical administration. The drug is a viscous translucent gel, packaged in special syringes with nozzles.
The main active ingredient of the drug is dinoprostone. One dose (it is equal to 3 g of gel) contains 0.5 mg of this substance.In addition, the composition contains triacetin and colloidal silicon dioxide.
Pharmacological properties of the drug
The main active component of the gel is dinoprostone (another name is prostaglandin E2). This substance is an unsaturated fatty acid, which is normally synthesized by the human body. This type of prostaglandin performs important functions, in particular enhances the blood supply to the tissues of the cervix uteri, which, accordingly, accelerates its softening and opening. In addition, the drug enhances the contractile activity of the smooth muscles of the uterus, which ensures the beginning of the birth process. By the way, dinoprostone affects not only the organs of the reproductive system - the drug affects the smooth muscles of the digestive tract and blood vessels.
After injection into the cervical canal, the gel is rapidly absorbed - its maximum concentration in the patient's blood is observed 30-45 minutes after the procedure. Prostaglandin binds to blood albumin (binding level is 73%). The drug in a woman's body disintegrates, forming at least nine metabolites, which are then excreted in the urine (only a small amount is excreted in feces).
When is the gel used? Main indications
In what cases it is advisable to use the drug "Prepidil-gel"? The instructions indicate that the drug is used to accelerate the maturation and opening of the cervix. Naturally, such therapy is possible only in the presence of medical indications.
Drug "Prepidil-gel": instructions for use
As already mentioned, in the pharmacy you can buy the drug, placed in a sterile syringe complete with a catheter. Immediately before use, you must remove the cap and attach the catheter to the tip of the syringe. The device must be inserted into the cervical canal, then slowly squeeze a portion of the gel from the syringe.
Immediately it should be said that the stimulation of the Prepidil gel is possible only in the conditions of a hospital. The procedure should be carried out by a doctor or nurse - attempts to administer the medicine on their own can only worsen the situation. After the introduction of the gel, the woman is recommended to lie down for 10-15 minutes on her back - this is how you can prevent the medicine from flowing out.
The initial dose is 0.5 mg of dinoprostone, which corresponds to the contents of a single syringe. If after the introduction of the drug no reaction is observed, the gel is injected again in the same amount, but not earlier than 6 hours after the previous procedure.The daily dose should not exceed 1.5 mg of active substance (equal to 9 g of gel).
Are there any contraindications?
Is it possible to use the drug "Prepidil-gel" to stimulate the birth process? Feedback from specialists, as well as the results of scientific research, state that the drug has a number of contraindications that you should definitely pay attention to:
- Long-term contractions of the uterus are dangerous in multiple pregnancies.
- The gel is not used if the patient has a history of more than 6 full-term pregnancies.
- Natural childbirth does not stimulate, if the insertion of the head of the fetus has not occurred.
- The drug is not prescribed to women with a history of severe childbirth, accompanied by injuries, cesarean section or gynecological surgical procedures (including surgery in the uterus).
- It should be understood that childbirth cannot be stimulated if the woman’s pelvis is too narrow and there are fears that the baby’s head will not pass through it.
- The gel is not prescribed in the presence of fetal distress, as well as in violation of the rhythm of the heartbeat of the child.
- The list of contraindications include the presence of the patient's bloody vaginal discharge of unknown origin during pregnancy.
- Childbirth cannot be stimulated if an abnormal fetus presentation was noticed during an ultrasound scan. In addition, the use of the gel can be dangerous in cases where surgery is more appropriate.
- Of course, the contraindications include allergic sensitivity of the patient to any component of the drug.
- It is worth mentioning the relative contraindications, which include hypertension, disorders of the liver and the excretory system, glaucoma, asthma, ophthalmic hypertension and certain diseases of the cardiovascular system. In such cases, the use of the gel is possible, but this should be done very carefully - the patient needs constant supervision.
Adverse reactions and complications during therapy
Is it possible to consider the drug "Prepidil-gel" safe? Reviews of doctors, and the patients themselves say that the drug is well tolerated and ensures the beginning of the birth process.On the other hand, the likelihood of complications due to the use of the gel is not excluded. Here is a list of possible side effects:
- Hypertonus of the uterus, increased and increased contractions of the uterine muscles, which can often lead to rupture of the walls of the organ, as well as premature dissection of the membranes of the fetus
- Vasovagal reactions are possible, including headaches, severe tremors, sensation of heat in the body, dizziness.
- The list of dangerous side effects include placental abruption.
- After the introduction of the gel may develop allergic reactions, which, as a rule, are accompanied by the appearance of irritation, redness and skin rash.
- Some patients complain of nausea, diarrhea and some other disorders of the digestive system (even despite intracervical administration of the gel).
- Possible bronchospasm, the development of asthma.
- Comparatively frequent violations of the circulatory and lymphatic systems. Adverse reactions include leukocytosis. After using the gel increases the risk of disseminated intravascular coagulation in patients after birth, which is very dangerous.
"Prepidil-gel" to stimulate childbirth is used quite often. But you need to understand that sometimes the medicine is dangerous for the fetus. For example, therapy may be associated with the development of distress syndrome, as well as acidosis and compression of the child. In the most severe cases, fetal death was recorded. According to statistics, side effects are rare and are most often associated with improper dosage or method of use of the gel.
Information on overdose: symptoms and treatment
Using too large doses of the drug "Prepidil-gel" is fraught with dangerous consequences. Patients develop uterus hypertonus, as well as an increase in the strength and frequency of uterine contractions. This, of course, affects the condition of the child - the complications include compression and acidosis of the fetus.
A woman in this condition should immediately receive medical care. To remove the hypertonus, beta-2 adrenomimetics are administered to patients. In severe cases, emergency delivery is indicated.
Prices and analogues of drugs
Of course, the cost of the drug is important for any patient.How much will the drug "Prepidil-gel"? The price of a syringe containing 3 g of gel varies from 600 to 700 rubles.
What to do if the medicine is not suitable for the patient or is it difficult to get it? There are some good analogues on the pharmaceutical market. The list of high-quality products include drugs such as "Prostenon" (in the form of a gel), "Prostin E2" and "Cerviprost". Of course, only a doctor can choose a substitute - use Prepredid or any other similar medicine is strictly forbidden.
Gel for stimulation of labor "Prepidil": reviews of patients and specialists
For many people, the important factor is the opinion of doctors about a particular medicine. In this case, experts unanimously argue that the drug "Prepidil-gel" copes with its main tasks, accelerating the maturation and disclosure of the cervix, which is sometimes necessary (for example, if childbirth is dangerous to the child or the mother). The drug has not so many contraindications, especially when compared with its counterparts. That is why doctors in certain cases prescribe women precisely “Prepidil-gel”.
Reviews of patients giving birth are also positive. The effect of the drug appears quickly, but women suffer very rarely from adverse reactions. The price of the gel is quite affordable, which is also important for many.