Should we use prostaglandins, tents or progesterone antagonists for cervical ripening before first trimester abortion?
Sixty-four women requesting first trimester termination of pregnancy were recruited into a comparative cohort study comparing the cervical ripening properties of a mechanical dilator (Lamicel; n = 17), prostaglandin, antiprogesterone and placebo control (n = 15), gemeprost; n = 17) and mifepristone; n = 15). Compared to the placebo group, all 3 active agents dilated the cervix (p < 0.02) and they significantly reduced the force required to dilate it to 8 mm Hegar (p < 0.001). Although Lamicel insertion resulted in the largest pre-operative cervical dilatation all agents are effective. Therefore the cervical priming agent of choice should be the most convenient to use and the one with least side-effects. The oral antiprogesterone, Mifepristone, is the easiest to administer and has less side effects.
Gupta
J K
JK
University Department of Obstetrics and Gynaecology, St James's University Hospital, Leeds, England.
Johnson
N
N
D000028:Abortion, Induced / Q000379:methods*; D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials / Q000009:adverse effects / Q000627:therapeutic use*; D002584:Cervix Uteri / Q000187:drug effects*; D015331:Cohort Studies; D004106:Dilatation; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate / Q000009:adverse effects / Q000627:therapeutic use*; D015735:Mifepristone / Q000009:adverse effects / Q000627:therapeutic use*; D011142:Polyvinyl Alcohol / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011453:Prostaglandins / Q000009:adverse effects / Q000627:therapeutic use*
D001672:Biocompatible Materials; C034860:Lamicel; D011453:Prostaglandins; D015735:Mifepristone; D008278:Magnesium Sulfate; D011142:Polyvinyl Alcohol