"Prepidil" (gel): description, instructions for use and reviews. Gel for delivery stimulation

Why use such a drug as "Prepidil" (gel)? Reviews about the effectiveness of the drug, as well as the testimony of this tool will be described a little lower. We will also provide information on how to use the drug, how much it costs and what its principle of action is.

Description, packaging and composition

What kind of packaging does the drug "Prepidil"? Gel intracervical goes on sale in polyethylene disposable syringes complete with a catheter. They are placed in contour mesh packaging and carton boxes respectively.

The translucent and viscous preparation "Prepidil" (gel) contains an active ingredient such as dinoprostone. As auxiliary substances, colloidal anhydrous silicon dioxide and triacetylglycerol are added to it.

Mechanism of action

What is the drug "Prepidil"? Gel at the birth stimulates the maturation of the cervix. Its active substance is an unsaturated fatty acid, which is synthesized under physiological conditions.

The specific principle of the drug during its intracervical use 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 uncovering). Such actions fully correspond to normally occurring generic changes, which lead to a decrease in cervical resistance and an increase in the contraction of the myometrium, as well as to delivery.

It should also be noted that the active element of the agent under consideration can also have a stimulating effect on the musculature of the digestive tract. In rare cases, this provokes nausea or vomiting in the parturient woman.

In high dosages, dinoprostone is able to lower blood pressure (due to the effect on the smooth muscles of blood vessels and capillaries), and also to increase body temperature. However, it should be noted that all these effects are not observed when the drug is correctly administered, that is, in the recommended doses for the maturation of the cervix.

Kinetics

What are the kinetic parameters of the drug "Prepidil"? The gel, the price of which is indicated below, after an intracervical injection of 500 μg reaches a maximum concentration in the blood after 35-45 minutes. After that, the active substance content rapidly decreases to the initial level (regardless of the contractile activity of the uterus).

Dinoprostone with human albumin binds to 73%. In this case, the active component of the drug is distributed over all tissues and biological fluids of the maternity organism.

To a large extent, dinoprostone is metabolized in the lungs, as well as in the kidneys and liver. In the urine and blood of a person, at least nine metabolites of prostaglandin E 2 are detected.

Most of the active substance "Prepidil" is excreted by the kidneys, and in small amounts - with feces.

Indications

What is the use of the drug "Prepidil"? The gel helps to stimulate the maturation of the cervix. It is used only in the presence of indications for labor.

Contraindications

Gel for stimulation of childbirth is not used in conditions for which prolonged uterine contractions are contraindicated. They include:

• Multiple pregnancies;
• No insertion of the fetal head;
• From 6 full-term pregnancies;
• Traumatic or difficult births (including in history);
• Surgical interventions on the uterus or cesarean section (including in history);
• Mismatch of the pelvis of the mother and the head of the fetus;
• Distress of the fetus (preceding);
• A situation in which surgical intervention is preferable;
• Violations in the rhythm of fetal heartbeats;
• Bleeding from the genital tract during pregnancy (of unknown origin);
• Infections of the genital tract (lower divisions);
• Abnormal presentation of the fetus ;
• Hypersensitivity to the ingredients of the gel.

With caution, the agent in question is used for arterial hypertension, cardiovascular diseases, violations of liver function, bronchial asthma, impaired renal function, opened fetal bladder, ophthalmic hypertension, or glaucoma.

The drug "Prepidil" (gel): instruction

As the initial dosage, use the entire contents of the syringe, using the attached catheter for this. It is injected into the cervical canal, which is located below the level of the internal pharynx.

Once the gel is injected, the woman in bed must lie ¼ hour on her back. This is necessary in order to minimize the leakage of the drug.

If the stimulation for the initial dose of the medicine did not occur, then the medication is administered again (after a lapse of 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.

The maximum daily dosage of the medicament in question is 1.5 mg.

Mode of application

How should I use the gel to stimulate childbirth? The instruction contains the following step-by-step actions:

• Remove a sterile syringe and catheter from the package.
• Remove the cap from the tip of the syringe.
• Insert the cap into the syringe (on the other side) to use it as a piston.
• Put the catheter (tightly) on the tip of the syringe so that there is a lye.
• Enter the contents of the syringe.

Adverse Reactions

What side effects can the drug "Prepidil" cause? Gel at the parturient is able to provoke titanic contractions of the uterus (increase in its tone, frequency and duration of contractions), as well as nausea, rupture of the uterus, vomiting, back pain, diarrhea, fever, hypersensitivity reactions and a feeling of heat in the vagina.

In the fetus, this drug can cause the development of distress syndrome, as well as change the heart rate, reduce the assessment of the state of the newborn on the Apgar scale to 7 points. Among other things, the use of this medication is rare, but still causes stillbirth.

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

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

Doctors say that to apply "Prepidil" you should first assess the compliance of the woman's pelvis and the size of the fetal head. If they do not match, they do not use the medication.

According to patients, the drug in question can cause a huge number of side effects, including life-threatening children. Therefore, most of them refuse to use this gel, especially after reaching 35 years of age.