Influence of different prostaglandin applications on cervical rheology

The softening effect of prostaglandin (PG) on cervical tissue prior to elective pregnancy termination is quantified by a new technique for the measurement of the elastance and relaxation of the cervix. The method is based on the pressure-volume relation of a compliant balloon placed in the cervical canal. These properties have been measured before and after different applications of prostaglandins in 58 patients electively terminating pregnancy. Application techniques used included high pressure jet application of PGE2 into the tissue of the portio uteri and the internal cervical os (120 micrograms), PGE2 and PGF2 alpha in Tylose gel (100 micrograms/0.5 ml); PGE2 as an intracervical tablet (150 micrograms) and PGE2 oral tablets placed into the posterior fornix of the vagina. Significant changes in cervical elastance were seen with the intracervically applied PGE2 in Tylose gel and the vaginally applied PGE2 tablets. The intracervically applied PGE2 gel also gave significant changes in cervical relaxation. No side effects other than mild cramping (2 patients) were seen with any of the applications in this study.