Cervical Ripening

Cervical Ripening General Information

During pregnancy, the uterine cervix plays an important role, having two major contributions. The name of cervix comes from Latin, meaning neck and it represents the lower portion of the uterus where it meets the top end of the vagina. This is why it is also known as the “neck of uterus” or as “cervix uteri”. It usually has a conical or cylindrical shape. In pregnancy, when the uterus dramatically enlarges, the cervix maintains the firmness so that the fetus can develop and remain in the uterus until the time of delivery. Cervical Ripening represents the physical and chemical processes that a cervix supports in preparation for labor and then delivery of the fetus. Cervical Ripening actually means the softening and effacing of the cervix that also becomes more distensible than usual (it gets shorter in the final month of pregnancy, but it respects its readiness to relax). The thinning is very important. The Cervical Ripening can be preinduced with some mechanical devices that have proved to have many advantages, such as a lower incidence of systemic adverse effects, a lower cost and a low risk of developing uterine hyperstimulation. The mechanical agents for this condition are efficient and safe, as the other agents that are used when dealing with this situation. Some examples that we can offer to you are: balloon catheters, hygroscopic dilators and other special devices designed for this. Despite of all these agents, there is no available method that can improve the perinatal outcome or the mode of delivery.

Cervical Ripening Symptoms

Cervical Ripening Treatment

There are many ways to treat Cervical Ripening and the treatment options can consist in prostaglandins, low-dose oxytocin infusions, antiprogesterone, relaxin, hygroscopic dilators, balloon catheter, membrane stripping, nitric oxide donors and cervical induction. The prostaglandins can be found in all the drug stores and can contain the two forms of dinoprostone. They ought to be administered in trials, each one having its own effects. The first one is prescribed as Prepidil and consists in a gel, which is placed inside the cervix, below the internal os. The gel is administered in 3 g doses in six hours. The patient has to take into consideration the fact that he must not use more three doses in 24 hours, because this can cause serious side effects. The second type of dinoprostone is Cervidil and has in its composition a ten mg dose of the prostaglandin, which is embedded in a mesh which is placed in the fornix of the vagina. The patient has to keep it there for 12 hours to allow the medicine to have an effect, and after this it has to be removed immediately. Another way to treat Cervical Ripening is the low dose oxytocin infusion, which must be performed by a specialist. The patient has to use a high dose of medicine form, being administered from one to four mU per min. Due to the fact that this kind of procedure can be stopped immediately, the scientists decided to apply this method in cases in which the patient is at a high risk of intolerance of the fetuses. There are cases, in which the doctor can prescribe antiprogesterone, also known as Mifepristone, considered an effective way to cure the disease. This medicine acts by binding the progesterone to the glucocoticoid receptors. In the inducing labor, the drug has proved to be very effective. Relaxin is another treatment option that can be recommended by doctors in treating Cervical Ripening. This kind of medicine has been first tested on animals, and proved to be effective in human patients too. There are cases in which the specialist can perform the balloon catheter procedure to heal Cervical Ripening. The operation consists in placing a 40 ml catheter, which contains a saline solution to induce and dilate the cervix inside the uterus. After this, the balloon is filled. It is important to apply some pressure on the lower area of the uterus or the cervix, during the operation, to cause stress in the inferior part of the uterine segment, which leads to a local production of prostaglandins. To treat the Cervical Ripening disease, there are many products that can be inserted inside the cervix to dilate it. These products can include Laminaria, fabricated from dried seaweed, Dilapan or Lamicel, fabricated from synthetic hygroscopic material. These medicines act by absorbing water from the cervix uteri, which can lead to the expansion of the dilators and, eventually, to the opening of the cervix. Another way to treat this condition is to use nitric oxide donors.