(For a general account of the prostaglandins see Chapter 15)

Prostaglandins that soften the uterine cervix (by an action on collagen) and have a powerful oxytocic effect include:

Dinoprost (prostaglandin F2a, PGF2a) (Prostin F2 alpha) and dinoprostone (prostaglandin E2; PGE2) (Prostin E2). They are used to induce labour and to terminate pregnancy, including missed or partial abortion and in the treatment of hydatidiform mole; they are given by intra- or extra-amniotic injection, by vaginal tablet, or intracervical gel, by i.v. infusion or by mouth. Their safe and effective use (including choice of route) requires special skill.

Adverse effects include vomiting, diarrhoea, headache, pyrexia and local tissue reaction.

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