[Preoperative cervical dilatation in abortion during the 1st trimester with sulprostone]

Retrospectively we have compared the efficacy, the immediate complications, and the side effects during termination of 727 first trimester pregnancies with and without preoperative cervical dilatation by sulprostone. All these patients had been admitted to the Frauenklinik der Medizinischen Hochschule L ubeck for legal abortion; 365 of them got a single intramuscular injection of 500 micrograms sulprostone 8-10 hours prior to vacuum aspiration (failure 4% Hegar less than 6); 81 patients got a single intramuscular-intracervical injection of 25 micrograms sulprostone 8-10 hours prior to vacuum aspiration (failure 16% Hegar less than 6); in 281 patients evacuation of the uterus was carried out in dilating the cervix mechanically. This route without preoperative dilatation by the prostaglandin analogue sulprostone gave the highest rate of complications. Only in regard to a complete evacuation of the uterus a single intramuscular-intracervical injection of sulprostone resulted in a diminution of the complications. However, a single intramuscular injection of 500 micrograms sulprostone prior to vacuum aspiration offered a practical, effective and relatively side-effect free method of cervical dilatation.