Prostin E2 helps induce labor for in-term or near-term people, who have favorable induction features and are carrying a singleton pregnancy with a vertex position.
What is prostin E2?
Prostaglandin E2, also called dinoprostone, is a naturally occurring substance that stimulates labor and is implicated in the inflammatory process.
Prostaglandin E2 is FDA-approved. It is used as a vaginal suppository from gestational weeks 12 to 20 as an abortifacient or to eliminate uterine contents to manage a missed abortion and intrauterine fetal death (within 28 weeks of pregnancy).
Prostaglandin E2 helps treat gestational trophoblastic disease. It is not a feticidal agent. Due to its oxytocic properties, prostin E2 should only be administered in the proper dosages by licensed medical professionals.
What is the mechanism of action of prostaglandin E2?
Prostaglandin E2 stimulates smooth muscles of the uterus and stomach. The exact mechanism of action is not fully understood.
A hypothesis suggests that the ability of prostaglandin E2 to regulate intracellular levels of cyclic 3, 5-adenosine monophosphate (cAMP), and cellular membrane calcium ion transport is responsible for its pharmacologic actions.
Prostaglandin E2 activates adenylate cyclase in several tissues, which promotes the synthesis of cAMP. The contractions of the gravid uterus brought on by prostaglandin E2 are like those brought on by forced labor in the term uterus. Cervical dilation and softening are other effects of prostaglandin E2.
What are the contraindications of prostin E2?
People hypersensitive to prostin E2 or dinoprostone or any other component in the medication should not use dinoprostone. People who are generally contraindicated for the use of oxytocic medications are also contraindicated for dinoprostone.
If any of the following is present, prostin E2 is contraindicated.
- Grand multiparity (sic or more previous-term pregnancies)
- Cephalopelvic disproportion
- Multiple gestations
- Obstetric conditions where either maternal or fetal benefit and risk ratio favors surgical intervention
- Previous uterine surgery (e.g. cesarean section, hysterotomy)
- Unexplained vaginal discharge and/or abnormal uterine bleeding during the current pregnancy
- Fetal heart rate pattern, indicating risk of fetal distress
- Engagement of the head is yet to happen
- Nonvertex position
What are the side effects of prostin E2?
Certain potential side effects often do not require medical treatment. During therapy, these side effects could fade away when your body gets used to the medication. Additionally, your healthcare provider might provide you with information to avoid or decrease some of these adverse effects.
Adverse effects of prostin E2 are rare. If they appear, medical attention could be necessary.
Consult your doctor straight away if you have any of the following negative effects appear:
- Fast or slow heartbeat
- Pressing or painful feeling in the chest
- Hives
- Swelling of the face, inside the nose and eyelids
- Trouble breathing
- Shortness of breath
- Increased pain in the uterus
- Weak or absent pulse in arms or legs
- Wheezing
- Tightness in chest
- Pale, cool, blotchy skin on arms or legs
Common side effects of prostin E2
- Abdominal or stomach cramps
- Fever
- Diarrhea
- Vomiting
- Nausea
If any of the above side effects persist and are troublesome or you have any concerns about them, speak with your doctor.
SLIDESHOW
Conception: The Amazing Journey from Egg to Embryo See SlideshowWhat are the precautions to take while using prostin E2?
Dinoprostone medications need to be used with caution in people with the following:
- Compromised cardiovascular, hepatic, or renal function
- Asthma
- Glaucoma
- Elevated intraocular pressure or chorioamniotic membrane separation
Prostin E2 is used intravaginally. Intracervical administration should not be done because there is a risk of accidental antigenic tissue damage and embolization, which occur later. Rarely, this could lead to amniotic fluid embolism or anaphylactoid syndrome during pregnancy.
Individuals who are 35 years or older, experience pregnancy-related difficulties and are pregnant for more than 40 weeks are more likely to develop postpartum disseminated intravascular coagulation. These variables may significantly elevate labor induction risks. Dinoprostone should be administered after evaluating all the risks. Taking precautions help identify any developing fibrinolysis in the first few days after giving birth.
Prostin E2 is only used in clinics and hospitals with specialized obstetric units.
Continuous electronic monitoring of uterine activity and fetal heart rate should be done while using this medication. For people with aberrant fetal cardiac rhythms, uterine hypertonias, or hypercontractility, a doctor must consider the requirements of the mother and the fetus before administering prostin E2. Any oxytocic medicine increases the risk of uterine rupture.
Dinoprostone (Vaginal Route). https://www.mayoclinic.org/drugs-supplements/dinoprostone-vaginal-route/side-effects/drg-20063461?p=1
NEW ZEALAND DATA SHEET. https://www.medsafe.govt.nz/profs/datasheet/p/prostine2vaggel.pdf
Prostin E2 20 mg vaginal suppository. https://healthy.kaiserpermanente.org/health-wellness/drug-encyclopedia/drug.prostin-e2-20-mg-vaginal-suppository.194103
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