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Precautions and Warnings With Dinoprostone Vaginal Insert

If you have had a previous C-section or have a history of asthma, make sure to let your healthcare provider know before receiving a dinoprostone vaginal insert. Several warnings and precautions apply to women with certain medical issues, so it is important that your healthcare provider has information on your medical history and any allergies you might have, as well as any medications you are taking.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to receiving a dinoprostone vaginal insert (Cervidil®) if you have:
 
  • Had vaginal bleeding during your pregnancy
  • Had a cesarean section (C-section) in the past
  • Had major surgery on your uterus
  • Any disease or condition that affects your uterus
  • Glaucoma
  • A history of asthma, even as a child
  • Any allergies, including to foods, dyes, or preservatives.
 
In addition, let your healthcare provider know if you are breastfeeding or taking any other medications, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With the Dinoprostone Vaginal Insert

Some warnings and precautions to be aware of prior to receiving this medication include the following:
 
  • Dinoprostone vaginal inserts should only be placed in the vagina by a trained healthcare provider in a hospital setting.
 
  • This medication may increase the risk for a blood clotting disorder that can cause serious bleeding after childbirth. Women who are 30 years of age or older, have had complications during pregnancy, or have been pregnant for longer than 40 weeks may have a higher risk for this problem.
 
  • Dinoprostone vaginal inserts have been associated with a serious condition known as anaphylactoid syndrome of pregnancy (sometimes called amniotic fluid embolism). This condition occurs when amniotic fluid enters the bloodstream through the placenta and causes an allergic response. Although it is rare, the condition is life-threatening, as it can lead to heart and lung collapse and bleeding.
 
  • You and your unborn baby will be closely monitored while the vaginal insert is in place. Your healthcare provider will check your cervix, the strength and frequency of your contractions, and how your baby is doing. The vaginal insert will be removed if:
 
    • Your contractions are unusually strong, long, or frequent
    • Your baby is in distress
    • You are experiencing certain side effects
    • Active labor begins.
 
  • Your healthcare provider will also remove the dinoprostone vaginal insert before you have an amniotomy (artificial rupture of the amniotic sac to induce labor).
 
  • Because some women may have an increased risk for certain problems from dinoprostone vaginal insert use, your healthcare provider may choose to monitor you more closely if:
 
    • Your "water broke" (ruptured membranes)
    • Your baby is not in the normal head-down position
    • You are carrying more than one baby
    • You have a history of unusually strong or frequent uterine contractions
    • You have glaucoma
    • You have a history of childhood asthma.
 
 
  • The dinoprostone vaginal insert is a pregnancy Category C medication. This means the medicine may not be safe for use during pregnancy (see Cervidil and Pregnancy), although obviously it is intended for use only in pregnant women.
 
  • It is unknown whether this medication passes through breast milk, although it is unlikely to do so. If you are breastfeeding or plan to start, discuss this with your healthcare provider prior to receiving the drug (see Cervidil and Breastfeeding).
 
Pregnancy and Pain

Dinoprostone Vaginal Insert Information

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