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prepidil used at our facility FREQUENTLY, esp. mon-fri. not too much on we's or nights (so i don't deal w/ it a lot), but we have lots of overdue, iugr, medical problem pt's being gel'd. protocol is efm for 30 min. prior to gel, 60 min. (at least afterward) and home if everything is o.k. i know some places keep people they gel. we do not. if there's a shortage of it, it's probably because we're using it all! (lol-not w/ our mighty 600 deliveries per year!) we use usually 1-2 gels on pt's prior to pitocin.
yuck pig semen. Prostin gel.....(expensive pig semen at that).... Yea we used it as recently as 3 years ago in the hospital in OK where I worked. However in the two hospitals I work here in WA State, it has not been used in eons. Either cytotec or cervidil (rarely) is used. The cytotec is given orally rather than lady partslly at the one place, which both us staff and patients LOVE (asyou can guess).
We use prostin for the majority of our inductions, rarely we use cervidil if they are really not ripe. Prostin usually works very well after about 2 doses if it is mixed right by pharmacy. Hardly ever use cytotec anymore, did a few years ago but not much these days.
So, how come you guys aren't using it anymore?
we used to use it and had good results, now the docs all switched to low dose pit induction. some work some don't. it seems to only work if cevix is ripe. i have no idea why they stopped no one has given me a real good answer. one doc told me he thoughtit was discontinued. but i did not think that was true.
I haven't seen Prepidil used in a few years but we do have one midwife who uses Cervidil regularly. Usually is placed in the evening and Pitocin started in the AM if the Bishop's score is at least 7. She usually uses it for postdate patients. Most of our other providers are using Cytotec. The Cervidil seems to be a little gentler as far as the ripening goes but it does take longer. The only real complaint I have heard from patients about the Cervidil is that is causes some lady partsl irritation. Some women have a little more discomfort with vag exams, occasionally someone will c/o lady partsl burning. The nice thing is that it can be removed for hyperstim/SROM/labor. It's rare but I did have to do it once.
Anita
mark_LD_RN
940 Posts
hi, does anyone still use prostaglandin gel to ripen cervix and induce labor any more we have not used it in about a yr or so. someone told me it was not being manufactured anymore.Is this true?