Using Cervidil (Dinoprostone) For Labor Induction

pregnant woman at hospital

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Cervidil is a brand drug used to dilate the cervix and induce pregnancies in women who are at the end of their pregnancy term or near the end. It comes in the form of a vaginal insert and contains prostaglandin.

Prostaglandin is a hormone that is produced in several parts of the body. Its function depends on which part of the body it’s made. 

Prostaglandin is responsible for controlling the menstrual cycle, ovulation, and inducing labor in the female reproductive system. A synthetic version of prostaglandin is used in Cervidil, to relax the muscles of the cervix and induce labor.

Cervidil is also known as dinoprostone, which is its generic name. It’s the only FDA approved vaginal insert for relaxing the cervix during labor.

How Cervidil Is Used During Labor

For delivery to occur, your cervix needs to open up, soften, and thin out. This process is called cervical ripening, and Cervidil can be used to trigger it if your cervix doesn’t do it on its own.

Cervidil is used as the first step in inducing a pregnancy. Its role is to soften and relax the cervix and prepare it for a baby to pass through. Cervidil serves any or a combination of these two main functions: 

  • Inducing contractions 
  • Softening the cervix 

You should know that Cervidil doesn’t work the same way for all women. In some women, it succeeds at only relaxing the cervix while it induces contractions in other women. The insert is removed when you no longer need it or after 24 hours.

A Cervidil insert might also be removed if: 

  • Your water breaks after it’s put in 
  • It doesn’t appear to be effective and your doctor wants to try a different medication to help your cervix relax
  • You’ve started labor
  • Your contractions are too strong 
  • Your baby appears to be in distress 

The effects of Cervidil stop almost immediately after the insert is taken out.

How Cervidil Is Administered

Cervidil is shaped like a slim tampon with a long tape attached. It must not be used without the tape, like with the string on a tampon, the tape on a Cervidil insert is needed to be able to pull it out later.

It is inserted through your vagina. It’s put in until contractions begin or for a maximum of twelve hours. Each insert of Cervidil contains 10 milligrams (mg) of dinoprostone. 

Cervidil can only be prescribed by a doctor and administered by a medical professional. Every hour the insert gradually releases 0.3 mg of dinoprostone into the vagina.

The maximum recommended period of usage is 24 hours. You are required to lay on your back as the insert is being put in, and asked to remain in that position for at least 30 minutes, after which you are allowed to move around. 

After Cervidil is inserted, the vagina is carefully monitored for any changes in the cervix. If contractions begin, the frequency and strength of the contractions are monitored. The baby’s health is also closely monitored to prevent adverse reactions. 

Who Cervidil Is Given To

Cervidil is only administered to women having a natural birth. However, it won’t be given to women who are having more than one baby.

Other situations in which Cervidil is not administered include: 

  • If you are already in labor
  • If your vagina can’t tolerate vaginal inserts. For instance, if you have a disease like genital herpes
  • If you have unusually strong contractions 
  • If your baby isn’t in the normal position it should be (which is with the head faced towards your pelvis)
  • If you’ve had a cervical surgery 
  • If a problem with your baby is detected
  • If your pelvis is too small, or the head of your baby is too large for a natural birth

Side Effects

Cervidil is relatively safe and few people report having any side effects on it. When side effects do occur, they are minor and include nausea, vomiting, headaches, or back pain.

If you have an allergic reaction to dinoprostone, Cervidil will not be given. If it has already been given, it will be removed if your doctor notices any signs of swelling, difficulty breathing, or development of hives. 

Precautions 

Before Cervidil is administered, the doctor will ask a couple of questions to ensure you don’t experience any adverse reactions to the drug. The questions usually include details of your family history, other medications you are currently on, and details of your medical history.

Administering Cervidil is strongly discouraged if the person in labor has:

  • Anemia: Cervidil is prescribed with caution to women who are anemic. This is because, when used to induce contractions, it might result in blood loss. In some cases, a blood transfusion might be needed. 
  • Asthma: For people with asthma, Cervidil might cause the blood vessels in your lungs and your lung passages to narrow as it induces contractions in your cervix. This might cause an asthma attack. 
  • A history of cesarean sections or uterine surgery: In women who have had a cesarean section or uterine surgery, prolonged contraction of the uterus might be unsafe for the fetus and damaging to the uterine. Administering Cervidil might cause a potential risk for uterine ruptures. If it’s used, the progress of your dilation will be carefully monitored. If there are any indications of uterine or fetal distress, the insert will be immediately removed. 
  • Other medication: You won’t be given Cervidil if you’ve been given or are going to be given any other medication that can induce labor like oxytocin for example.

Risks 

In rare cases, the use of medication that contains dinoprostone like Cervidil has been linked to the risk of developing amniotic fluid embolism. This condition causes amniotic fluid to enter your bloodstream resulting in a severe reaction that could lead to heart or lung failure. 

Women who are above the age of 30, women who experience any complications with their pregnancy, and women who have carried their babies for more than 40 weeks, have an increased risk of developing postpartum disseminated intravascular coagulation when Cervidil is used.

Disseminated intravascular coagulation is a condition where blood clots form easily and could block blood vessels, which can result in organ damage. However, it’s important to know that adverse reactions to the drug are rare. 

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4 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. US Food and Drug Administration. CERVIDIL

  2. NPS MedicineWise. Cervidil pessary. Consumer Medicine Information. Published May 1. 2018.

  3. MedlinePlus. Dinoprostone. Updated September 1, 2010.

  4. Kramer MS, Rouleau J, Baskett TF, Joseph K. Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study. The Lancet. 2006;368(9545):1444-1448.

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