[Facilitating cervix dilatation of the non-pregnant uterus by intracervical administration of gels containing prostaglandin and calcium chloride].

In a prospective, randomised study, 50 non-pregnant patients were treated intracervically with 3 ml 5% tylose, 50 micrograms sulprostone, 100 micrograms sulprostone gel, 3 ml 2.5 mM or 9.0 mM calcium chloride gel in order to soften the cervix 12-14 hours before diagnostic curettage. The gel was not used in a further 20 patients. To objectively demonstrate the priming effect, the force required for dilatation of the cervical canal was measured in Newtons, using a mechanical tonometer both before gel application and before the operation. In comparison with the administration of tylose only, the intracervical application of either sulprostone gel or calcium chloride gel led to a significant improvement in cervical dilatability. Tylose alone had a slight but measurable effect on the cervix. An increase in sulprostone from 50 micrograms to 100 micrograms or calcium molarity from 2.5 mM to 9.0 mM brought no further improvement in the dilatory effect. Dilatation-induced cervical lesions could be avoided by preoperative cervical ripening. After application of sulprostone, 3 out of 20 patients experienced doses-dependent uterine cramps, while all patients treated with calcium chloride gel were free of side effects. The intracervical administration of sulprostone and calcium chloride gel allowed gentle dilatation of the non-pregnant cervix, thus lowering the risk of uterine lesions. Under clinical aspects, cervical priming facilitates diagnostic and therapeutic procedures, which, in exceptional cases, can be performed without anaesthesia.