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Controlled Clinical Trial
. 2015 Oct 28:16:485.
doi: 10.1186/s13063-015-1003-8.

Analysis of cervical resistance during continuous controllable balloon dilatation: controlled clinical and experimental study

Petar Arsenijevic  1 , Marko Milosevic  2 , Aleksandar Zivanovic  3 , Biljana Milicic  4 , Branislav Jeremic  5 , Nenad Filipovic  6 , Zoran Protrka  7 , Petar Todorovic  8 , Slobodan Arsenijevic  9
Affiliations
Controlled Clinical Trial

Analysis of cervical resistance during continuous controllable balloon dilatation: controlled clinical and experimental study

Petar Arsenijevic et al. Trials. .

Abstract

Background: Hydraulic dilatation is a novel method of cervical dilatation that is based on continuous controllable dilatation (CCBD) by the pumping of fluid into the balloon extension of the system. The main advantage of this procedure is that it allows control of and insight into the process of cervical dilatation.

Methods: For the purposes of our research, we created a new and upgraded system for CCBD which consists of a programmed hydrostatic pump connected to a balloon extension. With regard to our aim to precisely measure and determine the location of the cervical resistance, we placed two pressure-measuring films, one on the top and one on the bottom of the balloon extension. This study included 42 patients in whom cervical resistance was measured before suction curettage.

Results: Cervical dilatation and measurement of cervical resistance were successful in all patients. The analysis of the pressure-measuring films showed that the points of highest resistance were located in the zone of the internal cervical os and that these values were much higher than those in the zone of the external cervical os (0.402 versus 0.264 MPa at the upper pressure-sensitive film; 0.387 versus 0.243 MPa at the lower pressure-sensitive film). This study also showed that an increase in cervical resistance in the zone of the internal cervical os was followed by an increase in cervical resistance in the zone of the external cervical os.

Conclusions: During CCBD, the internal cervical os is the centre of cervical resistance, and the values do not decline with the number of miscarriages or the number of previous births.

Trial registration number: ISRCTN Registry identifier: ISRCTN30949871 . Date of registration: 13 May 2015.

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Figures

Fig. 1
Fig. 1
Upgraded system for continuous controllable balloon dilatation: Nexus 6000 hydrostatic pump (National Instruments, Austin, TX, USA) (1), linear variable differential transformer displacement sensor (2), pressure sensor (3), dilatator device (4), driver for displacement sensor (5), enclosure with USB-6008 data acquisition card (6), laptop computer (7) and RS232 to USB converter (8)
Fig. 2
Fig. 2
Pressure-sensitive film. a Scheme of the pressure sensitive film; b Modified pressure sensitive film before dilatation
Fig. 3
Fig. 3
Pressure-sensitive films (PSFs) of patient 3 with cervical diameters and marked zones of internal and external cervical os: cervical length 54 mm, anteroposterior diameter 26 mm and laterolateral diameter 27 mm. a Upper PSF b Lower PSF
Fig. 4
Fig. 4
Pressure-sensitive films (PSFs) of patient 36 with cervical diameters and marked zones of internal and external cervical os: cervical length 50 mm, anteroposterior diameter 28 mm and laterolateral diameter 30 mm. a Upper PSF b Lower PSF
See this image and copyright information in PMC

References

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