[Dose-dependent effect of locally administered sulprostone gel on serum luteal and placental hormones in cervix priming in the 1st trimester].

In a prospective, randomised study 30 primigravidae were treated with 25 micrograms, 50 mu, or 100 micrograms sulprostone gel in order to soften the cervix prior to first trimester termination of pregnancy. 10 multigravidae received only the gel vehicle tylose. 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 (PG) application and before operation. Serum progesterone, 17-beta-estradiol and hP1 levels were determined radioimmunologically prior to PG application and at two-hours intervals until curettage. A sonographic examination for determing the vitality of the pregnancy was performed before PG administration and immediately before the surgical intervention. There were no significant differences in the primig effect between the 50 micrograms and 100 micrograms sulprostone-treated group; the application of 25 micrograms sulprostone was significantly less effective. After 100 micrograms sulprostone gel abortion occurred in 2 patients, 6 women showed a marked decrease in hPl concentrations, progesterone levels were found to be reduced to 31.6-78.7% and 17-beta-estradiol to 10-40% of the initial values before PG application. We found a close time correlation between the occurrence of contraction-induced lower abdominal pain and the fall in hormone concentrations. No abortions occurred in any of the patients treated with 50 micrograms sulprostone gel; in 9 women without clinical symptoms no significant changes of the hormone concentrations were observed. In contrast to the previously published literature our results indicate that effective cervical ripening can be achieved by this method without disturbance of the feto-placental unit and the trophoblast respectively.