Cervical Ripening: Treatment, Procedure, Cost and Side Effects
Last Updated: Oct 30, 2024
What is the treatment?
Cervical ripening is necessary for cervical dilation to take place during labor so that the baby can pass through and enter into this world. Oftentimes, cervical ripening takes too long to happen on its own and has to be induced so that the woman can go into labor. There are several methods that can help induce cervical ripening and consequenlty labor. Some of the commonest methods include medication and the use of artificial dilators. These methods help in the softening of the cervix so that it can dilate to 10cm, which is ideal for the vaginal birth of the baby. In certain severe cases, surgery may also be used to bring about cervical ripening and consequently, cervical dilation. That said, the best procedure will be dependent on the condition of the woman, her preferences and what her doctor recommends.
How is the treatment done?
Drugs and mechanical dilators are the commonest methods of ripening and dilating the cervix of a pregnant woman. Drugs are administered in two ways - either orally or they are inserted into the woman's vagina by a health care professional. These drugs help by relaxing and softening the cervix of the woman concerned, which consequently allows for the baby to pass through during delivery. As for mechanical dialators, they are of two kinds - hygroscopic dilators and balloon dilators. The procedure employed for both of these are slightly different. In the case of hygroscopic dilators, the vagina of the woman is first prepped with the help of antiseptics. Next, a tool known as sterile speuculum is used to examine cervix visually. Once that is done, the dilator is placed in the endocervix of the woman with its tails falling into the woman's vagina. Multiple dilators are placed till the endocervix seems to be full of them. Doctors place a sterlize gauze pad in the vagina of the woman so that the dilators stay in position. In the case of balloon dilators, a catheter is placed in the endocervix of the woman either with the help of a visualization device or by detecting the cervix with the help of fingers. After the catheter has been placed , the ballom reservoir in it is filled up with 30-50 mL of saline solution. the ballon is then retracted to bring about the softening of the cervix.
Who is eligible for the treatment? (When is the treatment done?)
Pregnant women who are near or past their due date and are facing a difficult time in the dilation of their cervix are eligible for this treatment.
Who is not eligible for the treatment?
Women who are suffering from other pregnancy complications or those who are still a couple of days away from their due date are not eligible for this treatment method of cervical ripening. Women who are allergic to the drugs used may also not be eligible.
Are there any side effects?
The drugs used for cervical ripening, whether oral or those inserted into the vagina, come with certain side effects. These include fever, vomiting, nausea, abominal pain and diarrhea. These side effects are usually mild and extremely uncommon. As for dilators, these usually do not have any side effects. However, if they are not sterile, then there are chances of an infection occuring.
What are the post-treatment guidelines?
There are no post-treatment guidelines as such for either the drugs or the dilators used to induce cervical ripening and dilation in pregnant women.
How long does it take to recover?
It takes about 12 hours for any of the treatment methods adopted (drugs or dilators) to soften and dilate the cervix of the woman and induce labor.
What is the price of the treatment in India?
The price of the drugs used for cervical ripening hovers arounds Rs. 500 per tablet. Cervical dilators are expensive and start at Rs. 6500 and go up to Rs. 18,000 depending on the brand and the type of the dilator.
Are the results of the treatment permanent?
Yes, the results of both the drugs as well as the dilators used for the ripening and the dilation of the cervix of the pregnant woman are permanent. However, the cervix will gradually go back to its natural size post the delivery of the baby.
What are the alternatives to the treatment?
Alternatives abound when it comes to methods employed for cervical ripening. Some of of the commonly adopted alternatives include herbal supplements, sexual intercourse, hot baths, breast stimulation, accupuncture, and in very rare cases, surgery. Surgery is not recommended though.
References
- Norström A, Radulovic NV, Bullarbo M, Ekerhovd E. Mast cell involvement in human cervical ripening. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2019 Jul 1;238:157-63. [Cited 23 July 2019]. Available from:
- Son S, Benson A, Hayes E, Subramaniam A, Clark E, Einerson B. Outpatient cervical ripening: a cost-minimization and threshold analysis. American Journal of Obstetrics and Gynecology. 2019 Jan 1;220(1). [Cited 23 July 2019]. Available from:
- Methods for Cervical Ripening and Induction of Labor- American Family Physician [Internet]. aafp.org 2003 May 15;67(10):2123-2128. [Cited 23 July 2019]. Available from:
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