Vaginal administration of gemeprost for preoperative cervical dilatation in non pregnant patients

Abstract

The use of Gemeprost vaginal suppositories has been evaluated in a trial for induction of the cervical dilatation in non pregnant women. 30 voluntary patients, 22 nulliparous and 8 pluriparous, had to be subjected to biopsy of the endometrium; 24 were treated for the control of sterility and 6 for menstrual perimenopausal disorders. The biopsies of the sterility control were effected in the second half of the cycle, generally without having recourse to narcosis. A single Gemeprost pessary containing 1 mg of 16, 16-dimethyl-trans-delta 2 PGE1 methyl ester was intravaginal administered, deeply into the posterior fornix, 3 hours before the biopsy. The success rate was 86.66 (26 pts.) with an average dilatation of 5.38 H (Hegar) +/- 0.75 SD. For 4 patients (13.33%) having a dilatation less than 4 H, it was necessary to complete the dilatation mechanically. All the observed side effects presented a modest intensity: cephalalgia 6.6% (no. 2), gastralgia 3.3% (no. 1), vaginal burning 6.6% (no. 2). No significant variation of vital function parameters was recorded. In conclusion this type of preparation of the cervix has permitted us to achieve a more gradual dilatation and to prevent the traumata of the cervico-isthmic system due to forced mechanical dilatations by the exclusive use of Hegar's dilators.