[Preoperative cervix priming in the 1st trimester: initial clinical experiences with a combination of Pluronic F 127 and sulprostone].

A new gel with sulprostone was applied in a prospective randomized study in 70 patients who were scheduled for termination of 1st trimester pregnancy. Priming was carried out in two equal groups of 25 patients with 50 micrograms or 100 micrograms sulprostone gel respectively; in a control group of 20 patients the gelatinizing agent (Pluronic F 127) was used without sulprostone. The gel, which was produced immediately before the application, was applied intracervically with a semiflexible polyethylene catheter with a constant injection volume in a three-hour interval before the operation. A dilatation response--documented by the free patency of Hegar's dilatator which effortlessly passes the outer and inner uterine cervix--was seen in the therapy group; among these patients an average dilatation of the cervical canal of 8.2 mm (SD +/- 2.25) was achieved. This therapeutic effect was better in primiparae and multiparae compared with nulliparae (p less than 0.05). No statistically significant dose-effect correlation was found between the patients who had been treated with 50 micrograms sulprostone and those who had been treated with the 100 micrograms dosage. Among the side effects a dose-independent spastic lower abdominal pain was seen most frequently; it was noticed in 10 patients. Based on the results of this study it is concluded that cervical priming with sulprostone-pluronic gel can be regarded as a practicable method with a low rate of side effects for preoperative cervical priming in patients scheduled for termination of first trimester pregnancy.