Preoperative administration of prostaglandin to avoid dilatation-induced damage in first-trimester pregnancy terminations

Abstract

A prospective, randomized, controlled study was carried out to investigate the dilating and softening effect on the cervix of prostaglandin F2-alpha gel administered intracervically and of prostaglandin E2 tablets administered orally. A total of 581 patients were included in the study: 149 received 2.5 mg prostaglandin F2-alpha in gel form intracervically, 150 received 1 mg prostaglandin E2 in tablet form orally, 138 were given placebo gel and 144 no medication at all. In the group given prostaglandin F2-alpha gel intracervically, success was achieved in 85.8% of patients and partial success in 8.8%. In the group given prostaglandin E2 tablets orally, the results were successful in 29.4% and partially successful in 40.6%. The incidence of side effects in the group given prostaglandin F2-alpha gel was rather high - 53%. The results show that prostaglandin can bring about a certain softening of the cervix, but side effects cannot be ruled out. Nevertheless, priming of the cervix is to be recommended in young primigravidas.

PIP: To prevent complications with 1st-trimester abortions, it has been felt that use of a chemical method of dilatating the cervix would be preferable to the mechanical methods which have been used previously. A prospective, randomized, controlled experiment was done to test the effectiveness of PGs (prostaglandins) in inducing cervical dilatation. A total of 581 patients were used: 149 received 2.5 mg PGF2alpha intracervically in gel form, 150 received 1 mg PGF2 orally in tablet form, 138 were given placebo gel, and 144 received no medication. Results are tabulated. The intracervical gel was most successful in inducing cervical dilatation, achieving a success rate of over 85%. Oral PG tablets were successful in 40.6% of the cases. Side effects occurred only in the PG cases, and they occurred at a high incidence rate. Side effects were most prevalent with the intracervical gel. Very severe pain and heavy bleeding were the most disagreeable and frequent side effects. It is concluded PGs are effective in priming the cervix of young primigravidas. However, side effects cannot be ruled out.