Prostaglandin E2 pessaries to facilitate first trimester aspiration termination

Using a double blind administration protocol, the effect on the cervix of prostaglandin E2 (PGE2) vaginal pessaries inserted one to six hours before aspiration termination of pregnancy has been assessed. Pessaries containing 10 mg of PGE2 produced significant cervical softening and dilatation compared with those containing only 5 mg of PGE2 or placebo, the effect was almost as good as 15 mg of PGE2 but the lower dose caused fewer gastro-intestinal side-effects and uterine cramps. Blood loss at abortion and in the early post-abortal recovery period was significantly reduced following PGE2 treatment compared with placebo. The method described is simple and effective in reducing difficult cervical dilatation and is appropriate for day-care abortion management.