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Re: cervical ripeningFrom: Ira Bachman, MD (awogc@aol.com)Tue Feb 27 20:48:06 2001
I would like to use misoprostol, but have met resistance from the administration. They seem to value Searle's opinion more than ACOG's. At Tue, 27 Feb 2001, Luis Sanchez-Ramos, MD wrote: > >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.
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