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Re: cervical ripening From: Luis Sanchez-Ramos, MD (sanchez-ramos@worldnet.att.net) Tue Feb 27 20:17:07 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Ira Bachman, MD: "Re: cervical ripening" Previous message: Ira Bachman, MD: "Re: cervical ripening" In reply to: Ira Bachman, MD: "Re: cervical ripening" Next in thread: Ira Bachman, MD: "Re: cervical ripening" Reply: Ira Bachman, MD: "Re: cervical ripening" Ira: My recommendation is to use misoprostol: it ripens the cervix and induces uterine activity and it is very economical. Multiple doses of Cervidil would be very costly. The literature regarding the use of Cervidil is sparce. There are numerous articles assessing the efficacy of dinoprostone (PGE2)but most of these studies deal with the intravaginal administration of PGE2. Many studies also assessed the efficacy of intracervical administration of dinoprostone, i.e, Prepidil as well as hospital compounded products. Now, with regard to (slow release 10 mg vaginal insert of PGE2) Cervidil; not many studies are available. It was approved by the FDA based on the "other" PGE2 studies and effectiveness compared to placebo. We performed a meta-analysis comparing Cervidil with misoprostol and showed that the latter was more effective and cheaper. LSR At Tue, 27 Feb 2001, Ira Bachman, MD wrote: > >Maybe Luis can help. I believe he has published quite a bit on cervical >ripening. >At Tue, 27 Feb 2001, Braun, R. Daniel wrote: >> >> I am not aware of any literature. One of our MFM's does it however and he >>swears by it. He is not aware of any literature either. >> >>Dan >> >>-----Original Message----- >>From: awogc@aol.com >>To: Multiple recipients of list OB-GYN-L >>Sent: 2/27/2001 4:45 PM >>Subject: cervical ripening >> >>In an effort to lower the cesarean section rate in our hospital, the >>department director recommended more use of cervidil. He stated that if >>one dose doesn't work (improve your bishop score) try a second or a >>third. >>Is anyone aware of any literature that demonstrates that multiple doses >>work better than one dose? >>I've serached,but haven't found anything. Next message: Ira Bachman, MD: "Re: cervical ripening" Previous message: Ira Bachman, MD: "Re: cervical ripening" In reply to: Ira Bachman, MD: "Re: cervical ripening" Next in thread: Ira Bachman, MD: "Re: cervical ripening" Reply: Ira Bachman, MD: "Re: cervical ripening"

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