Dilatation of the cervix prior to vacuum aspiration by single vaginal administration of 15-methyl-PGF 2α methyl ester

Abstract

Vacuum aspiration after mechanical dilatation of the cervical canal is the most used method for termination of late first trimester pregnancy. Dilatation and evacuation (D & E) is common in USA as an alternative procedure for second trimester abortion. Both methods are fast and effective but concern for traumatic complications and the effect of cervical injury on long-term reproductive behaviour has focused the interest on more physiological methods for producing dilatation of the cervical canal. The present study describes the efficacy and safety of treatment with one vaginal suppository containing 15-methyl-PGF 2α methyl ester prior to vacuum aspiration in the 9th to 14th week of pregnancy in 489 patients. Patients in the 9th to 12th week (Group I) received 1.0 mg and those in the 13th to 14th week (Group II) 2.5 mg of the compound. Vacuum aspiration was performed 12 hours later. Mean cervical dilatation at operation was in Group I 9.4 mm and in Group II 10.9 mm. In approximately 50% of the patients, additional dilatation of 2 to 3 mm were necessary but was accomplished with minimum resistance. Side effects in terms of vomiting and diarrhea were common but were only in rare cases frequent enough to be regarded as disturbing to the patient. No cervical laceration could be observed and no perforation of the uterus occurred at the operation.