Cervical dilatation in late first trimester termination by prostaglandin, hylase and isogel.

ABSTRACT

PIP: Preoperative dilatation of the cervix was attempted in 223 cases prior to vacuum aspiration in patients seeking late first trimester termination beyond 10 weeks. 15 Me PGF2alpha was used in the form of vaginal suppositiories, intramuscular and intracervical injections. Dilatation of cervix of 10 mm or more was achieved within 4 hours in 86% cases with intracervical injections. Gastrointestinal disturbances caused by intramuscular injections could be avoided by intracervical injections, as the amount of (PG) prostaglandin required was only 100 ugm, but the success rate was significantly lower. The success with multiple dose suppositories was 80%. There was no significant difference in the success with 1.5 mgm or 1.0 mgm dosage, but the side effects were significantly higher with 1.5 mgm suppositories. Intracervical Hylase did not dilate the cervix but successfully softened it within 5 minutes to make metallic dilatation simple. The hygroscopic Isogel tents achieved dilatation of 10 mm or more in 73% of the patients in 12 hours. The tents as well as intracervical PG injection had the disadvantage of requiring an additional theater procedure prior to suction curettage.