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Discussion

Cervidil guidelines

Does anyone have a specific guideline for when it is appropriate to use Cervidil for cervical ripening? We are working on guidelines for when it is appropriate for the doctor to use it.

Case in point: G1 P0 dilated to 2 cm had Cervidil placed. Is that appropriate? I thought Cervidil was mainly for cervical ripening. Does it make sense to use it if the patient is already 2 cm?

Does your facility have any more concrete guidelines for when Cervidil is used?

Thanks for your help!!!

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    How effaced was the cervix? Just because you are dilated, doesn't mean you are "ripe" per se, especially in a prime. The 1-2 cm dliated prime can be squirrely, and maybe a little ripening would increase the chances of success for the induction. You have to factor in the Bishop score, which is something providers really need to assess to insure the success of any induction (and often times overlooked). AWHONN has a position statement on cerivical ripening, as does ACOG...you may do well in accessing those to create your guidelines/policy.

    I worked with a doctor many years ago who used Prepidil as his induction method. Would use it in patients that were 4 cms and above and shoot the baby out. It certainly worked, but scary stuff.

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