Therapeutic considerations for preinduction cervical ripening with intracervical prostaglandin E2 gel.

A commercially prepared prostaglandin E2 (PGE2) gel for cervical ripening has been approved by the U.S. Food and Drug Administration (FDA). In circumstances when labor must be induced before the cervix has undergone spontaneous softening and effacement, this product effectively prepares the cervix for labor. Compared with extemporaneous preparations for vaginal administration, this product offers stability, uniform dosage and minimal side effects. Intracervical PGE2 gel offers significant clinical benefits, but also requires consideration of important clinical issues related to the selection of patients, application of the gel and subsequent monitoring of the patient and fetus.