title: Dilatation of the cervix with dinoprostone ('Prepidil gel') prior to insertion of an intrauterine device: report of two cases.
abstract: Routine insertion of an intrauterine device (IUD) is usually a simple procedure in parous and nulliparous subjects. There is normally very little cervical resistance, depending on the type of IUD used. We describe two cases in which cervical dilatation to allow passage of an IUD was facilitated by the intracervical insertion of 0.5 mg of PGE2 gel. The use of PGE2 gel in subjects where there appears to be marked cervical resistance at the level of the internal os probably allows safer introduction of the IUD using less force than after using analgesia to the cervix alone or a paracervical block. It is also faster and more convenient than using osmotic dilators. We recommend the use of 0.5 to 0.25 mg of PGE2 gel inserted into the cervix about half an hour to two hours prior to attempting insertion of the intrauterine device in women in whom there appears to be an abnormally high resistance at the level of the internal cervical os. The method appears to be simple and physiologically acceptable.
authors.affiliation: Department of Obstetrics and Gynaecology, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: M C
authors.initials: MC
authors.lastname: van der Griendt
authors.forename: N D
authors.initials: ND
authors.lastname: Goldstuck
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D002584:Cervix Uteri / Q000187:drug effects*; D004106:Dilatation; D015232:Dinoprostone / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005782:Gels; D006801:Humans; D007434:Intrauterine Devices
chemical_list: D005782:Gels; D015232:Dinoprostone