[Gemeprost vaginal suppositories versus intracervical sulprostone gel administration for cervic priming in the 1st...

In a prospective, randomised study, 40 primi- and plurigravida were treated either intracervically with 50 micrograms Sulprostone gel or vaginally with a pessary containing 1 mg Gemeprost in order to soften the cervix prior to first trimester termination of pregnancy. Curettage was performed on average 6.0 and 3.2 hours, respectively, after prostaglandin administration. For objective demonstration of the priming effect, the force required for dilatation of the cervical canal was measured in Newton by a special tonometer before prostaglandin treatment and before operation. The free passability of the cervical canal, the maximal dilatability with a force of 10 N and the increase in dilatability after local prostaglandin application were measured. A modified visual analogue scale was used to evaluate the subjective pain experience. During the time between administration and curettage, no abortion occurred in any of the patients. There were no statistically significant differences between both groups regarding the free passability and the maximal dilatability, however, the increase in dilatability was significantly greater in the Gemeprost group. The visual analogue scale allows the patient to quantify, at least to some extent, her experience of pain, but there were no differences in the rate of uterine cramps between both groups; gastrointestinal symptoms did not occur. Both methods were found to be equally efficient; the advantages of Gemeprost are the ease of administration and the short application-curettage interval; however, the cost for one Gemeprost application is nearly 6-fold higher than that of one Sulprostone gel application.