[Cervical maturation using Prepidil gel in pregnancy termination in primigravidas]

Area of Science:

• Obstetrics and Gynecology
• Pharmacology
• Reproductive Medicine

Background:

• Therapeutic abortion in primigravida often requires cervical preparation.
• Pharmacological cervical ripening can facilitate the procedure.

Purpose of the Study:

• To evaluate Dinoprostone (Prepidil Gel) for pharmacological cervical ripening before therapeutic abortion in primigravida.
• To compare the efficacy and safety of 4-hour versus 6-hour intervals between gel application and abortion.

Main Methods:

• A randomized study of 73 primigravid patients undergoing therapeutic abortion.
• Patients were divided into two groups: 6-hour and 4-hour intervals post-Dinoprostone gel application.
• Cervical maturation assessed by Hegar's sign, and abortion procedure details were recorded.

Main Results:

• Cervical maturation was comparable in both groups (average delta Hegar I: 7.32, delta Hegar II: 7.02).
• 82% of patients required only local anesthesia; additional mechanical dilatation was needed in 20%.
• The 4-hour group had less frequent uterine hyperstimulation (17.95%) compared to the 6-hour group (35.29%) and fewer gastrointestinal side effects (41.03% vs 29.41%).

Conclusions:

• Dinoprostone gel is effective for cervical ripening prior to therapeutic abortion in primigravida.
• A 4-hour interval appears to offer a better balance of efficacy and reduced uterine activity and side effects compared to a 6-hour interval.