Composition
Vaginal Pessary/Tab 3 mg/10 mg: Dinoprostone (Prostaglandin E2) 3 mg/10 mg. Vaginal Gel 2 mg: Per ml: Dinoprostone 800 mcg; 2.5 ml (2 mg).Vaginal Gel 1 mg/3 gm: Per 3 gm: Dinoprostone 1 mg; (
Indications & Dosage
Induction of labour: Adults: Vaginal Gel: inserted high into posterior fornix (avoid administration into cervical canal), 1 mg vaginal gel (unfavourable primigravida 2 mg), followed after 6 hr by 1-2 mg vaginal gel if required; max gel 3 mg (unfavourable primigravida 4 mg). Vaginal Pessary/Tab: inserted high into posterior fornix; 3 mg vaginal tab/pessary, followed after 6-8 hr by 3 mg vaginal tab/pessary if labour is not established; max 6 mg vaginal tab/pessary. By IV INF: Adult: 1 mg inj: See literature. Termination of pregnancy: By IV INF: Adult: 10 mg inj: See literature.
Administration
Continuous IV infusion: Administered either centrally or peripherally. Do not administer bolus and take care not to quickly flush lines that may contain dinoprostone. Dilute 500 mcg (0.5 ml) of the 1 mg in 1 ml injection solution to 5 ml with 0.9% NaCI to give 100 mcg in 1 ml, Use this 100 mcg in 1 ml solution to make up a 50 ml syringe for infusion.
Contraindications
Active cardiac disease, active pulmonary disease, avoid extra-amniotic route in cervicitis or vaginitis, fetal distress, fetal malpresentation, grand multiparas, history of caesarean section, history of difficult or traumatic delivery, history of major uterine surgery, major cephalopelvic disproportion, multiple pregnancy, placenta praevia or unexplained vaginal bleeding during pregnancy, ruptured membranes, untreated pelvic infection, avoid in hepatic or renal impairment
Precautions
Effect of oxytocin enhanced, history of asthma, history of epilepsy, history of glaucoma and raised intraocular pressure, hypertension, risk factors for disseminated intravascular coagulation, uterine rupture, uterine scarring, monitor uterine pain and fetal status
Interactions
Oxytocin.
Side Effects
Abruptio placenta, amniotic fluid embolism, backache, bronchospasm, cardiac arrest, diarrhoea, disseminated intravascular coagulation, fetal distress, fever, low Apgar scores, maternal hypertension, nausea, pulmonary embolism, rapid cervical dilation, severe uterine contractions, stillbirth or neonatal death, uterine hypercontractility with or without fetal bradycardia, uterine hypertonus, uterine rupture, vaginal symptoms (warmth, irritation, pain), vomiting