Abstract
Vacuum aspiration is the most common method of termination of pregnancy in the first trimester. Mechanical dilatation of the cervix can lead to cervical laceration and uterine perforation. There is also concern about the effect of cervical injury on subsequent reproductive performance1, 2. Therefore various types of natural prostaglandins and prostaglandin analogues have been used to dilate the cervix before vacuum aspiration in order to reduce the incidence of trauma to the cervix. Although most of the studies reported were not properly controlled, the data from the few controlled trials did show that some natural prostaglandins and prostaglandin analogues were effective in pre-evacuation cervical dilatation 3–6. It is interesting that a significant proportion of primigravid patients (11%) treated with placebo pessaries had a cervical dilatation of 8 mm or more6. This may be due to the release of endogenous prostaglandins during vaginal insertion7 or it may just be the result of cervical changes during pregnancy. So far the possible effects of placebo vaginal pessaries have not been studied.
Keywords
- Cervical Dilatation
- Prostaglandin Analogue
- Uterine Perforation
- Vaginal Administration
- Mechanical Dilatation
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Wright, C. S. W., Campbell, S. and Beazley, J. (1972). Second trimester abortion after vaginal termination of pregnancy. Lancet, 1, 1278
Pantelakis, S. N., Papadimitriou, G. C. and Doxiadis, S. A. (1973). Influence of induced and spontaneous abortions on the outcome of subsequent pregnancies. Am. J. Obstet. Gynaecol, 116, 799
Brenner, W. E., Dingfelder, J. R., Staurovsky, L. G. and Hendricks, C. H. (1973). Vaginally administered PGF2α for cervical dilatation in nulliparas prior to suction curettage. Prostaglandins, 4, 819
Cheng, M. C. E., Karim, S. M. M. and Ratnam, S. S. (1975). Pre-operative cervical dilatation with 15(S)-15-methyl prostaglandin E2 methyl ester in first trimester nulliparae — a double blind study. Contraception, 12, 59
WHO Prostaglandin Task Force (1981). Vaginal administration of 15-methyl PGF2α methyl ester for pre-operative cervical dilatation. Contraception, 23, 251
Mackenzie, I. Z. and Fry, A. (1981). Prostaglandin E2 pessaries to facilitate first trimester aspiration termination. Br. J. Obstet. Gynaecol., 88, 1033
Mitchell, M. D., Flint, A. P. F., Bibby, J., Brunt, J., Arnold, J. M., Anderson, A. B. M. and Turnbull, A. C. (1977). Rapid increases in plasma prostaglandin concentrations after vaginal examination and amniotomy. Br. Med. J., 2, 1183
Nakano, R., Hata, H., Sasaki, K. and Yamamoto, M. (1980). The use of prostaglandin E1 analogue pessaries in patients having first trimester induced abortions. Br. J. Obstet. Gynaecol., 87, 287
Smith, S. K. and Baird, D. T. (1980). The use of 16,16-dimethyl-trans-Δ2 PGE1 methyl ester (ONO-802) vaginal suppositories for termination of early pregnancy. A comparative study. Br. J. Obstet. Gynaecol., 87, 712
Prasad, R. N. V., Lim, C., Wong, Y. C., Karim, S. M. M. and Ratnam, S. S. (1978). Vaginal administration of 16,16-dimethyl-trans-Δ2 PGE1 methyl ester (ONO-8O2) for pre-operative cervical dilatation in first trimester nulliparous pregnancy. Singapore J. Obstet. Gynaecol., 9, 69
Hale, R. W. and Pion, R. J. (1972). Laminaria: an underutilized clinical adjunct. Clin. Obstet Gynaecol., 15, 829
Manabe, Y. and Manabe, A. (1981). Nelaton catheter versus laminaria for a safe and gradual cervical dilatation. Contraception, 24, 53
Quinn, M. A., Jalland, M., Wein, R. and Kloss, M. (1981). Vaginal prostaglandin F2α gel before first trimester terminaton of pregnancy. Aust. N.Z. J. Obstet. Gynaecol., 21, 93
Karim, S. M. M., Ratnam, S. S., Selvadurai, V., Wun, W. and Prasad, R. N. V. (1977). Cervical dilatation with 16,6-dimethyl PGE2 p-benzaldehyde semicarbazone ester prior to vacuum aspiration in first trimester nulliparae. Prostaglandins, 13, 333
Bygdeman, M., Bremme, K., Christensen, N., Lundstrom, V. and Gréen, K. (1980). A comparison of two stable prostaglandin E analogues for termination of early pregnancy and for cervical dilatation. Contraception, 22, 471
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1983 MTP Press Limited
About this chapter
Cite this chapter
Ho, P.C., Liang, S.T., Tang, G.W.K., Ma, H.K. (1983). Pre-evacuation cervical dilatation in termination of pregnancy. In: Karim, S.M.M. (eds) Cervagem. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-7298-1_5
Download citation
DOI: https://doi.org/10.1007/978-94-011-7298-1_5
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-011-7300-1
Online ISBN: 978-94-011-7298-1
eBook Packages: Springer Book Archive