Cervical dilation

Cervical dilator. Isaptent, prepared from granulated Plantago ovata seed husk, administered as a cervical dilator to 804 women between 15 and 45 years of age, achieved satisfactory dilatation in 94% of the cases. The cervical dilatation bore no relationship to age, parity, and gestation period of the subjects. There was no apparent damage to the cervix, and the vaginal flora remained unchanged in the randomly selected subjects . 

Karim, S. Ratnam, S. Prasad, R. Wong, Y. Vaginal administration of a single dose of 16, 16 dimethyl prostaglandin E2 p-benzaldehyde semicarbazone ester for preoperative cervical dilatation in first trimester nulliparae. Br. J. Obstet. Gynecol. 1977, 84, 269-271. 

Bennett, M. Horrowitz, S. Wass, D. The use of 16, 16-dimethyl-PGEl-deltamethyl ester (cervagem) vaginal pessaries for cervical dilatation prior to evacuation for second trimester termination. Austr. New Zealand J. Obstet. Gyn. 

A 32-year-old woman in her 25th week of gestation was hospitalized for endouterine fetal death (6). She had had two previous cesarean sections. Cervical dilatation was induced with a Hagar dilator and laminaria tents, and sudden spontaneous and strong contractions led to uterine rupture. 

In another randomized, double-blind study in 40 primi-parous women in labor at less than 5 cm cervical dilatation who requested epidural analgesia, the addition of clonidine 75 micrograms to epidural sufentanil 20 micrograms did not provide any advantages in analgesic efficacy or adverse effects (7). 

In a prospective dose-finding study, 170 women with cervical dilatation of 3-5 cm were randomized to receive intrathecal sufentanil 0, 2.5, 5.0, 7.5, or 10 micrograms combined with bupivacaine 5 mg (13). Bupivacaine combined with 2.5 micrograms sufentanil provided analgesia comparable to higher doses with a lower incidence of nausea and vomiting and less severe pruritus. 

Sulpro stone Nalador Sobering AG CP-34089 SHE 286 ZK-57671 Cervical dilation 500 /Jig per 3-6 h IV Termination of pregnancy 100-500 /Ltgh IV... 

Tocolytic therapy should not be used in cases of intrauterine infection, fetal distress, severe preeclampsia, vaginal bleeding, and maternal hemodynamic instability. The criteria for starting tocolysis are regular uterine contractions with cervical change. In women with cervical dilatation >3 cm, tocolytic therapy is less effective. ... 

Oxytocin is secreted in response to cervical dilation and uterine contractions during labour. By a positive feedback mechanism, oxytocin brings about further contraction of the utems until parturition is complete. Oxytocin is used clinically to induce or augment labour. 

AUGMENTATION OF DYSFUNCTIONAL LABOR To augment hypotonic contractions in dysfunctional labor, it rarely is necessary to exceed an infusion rate of 10 mlU/min, and doses of >20 mlU/min rarely are effective when lower concentrations fail. Potential complications of overstimulation include trauma of the mother or fetus due to forced passage through an incompletely dilated cervix, uterine rupture, and compromised fetal oxygenation due to decreased uterine perfusion. Oxytocin usually is effective when there is a prolonged latent phase of cervical dilation and when, in the absence of cephalopelvic disproportion, there is an arrest of dilation or descent. 

The results reported by Friedman in the 1950s still serve as the basis for diagnosing delayed labor [3,4]. Arrest of labor during the first stage (the stage of cervical dilatation) is the absence of any progression of labor over a period of 2 h. The second stage (complete dilatation of the cervix until the onset of expulsive contractions) should not exceed 2 h. 

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