Intravaginal prostaglandin E2 gel and cardiovascular changes in hypertensive pregnancies

Prostaglandin E2 (PGE2) and its analogues may be potent vasodilators, and intravaginal PGE2 is known to be absorbed rapidly into the maternal circulation. This study investigated any cardiovascular effects from intravaginal PGE2 on 42 hypertensive pregnant women requiring preinduction cervical ripening. Declines in maternal diastolic, systolic, and mean arterial pressures were apparent during the first half hour. This trend was mild, was reversible without treatment, and did not influence the fetal heart rate baseline or patterns. Fear of clinically significant changes should not be a concern, but monitoring during the first hour is recommended.