[Dilatation of the cervical canal with Dilapan before induced abortion in the first trimester of pregnancy in primigravidas].

During the period between Oct. 1, 1993 and June 30, 1994 the authors inserted by the intracervical route in 32 primogravidae with unwanted pregnancies before abortion with pregnancies shorter than 8 weeks a hydrophil dilator Dilapan. After 12 hours the rod was removed under general anaesthesia and the pregnancy terminated by vacuum aspiration. In three instances after Dilapan insertion slight haemorrhage occurred which, however, did not call for removal of the rod. Apart from slight tenderness in the hypogastrium, similar as during menses, no side-effects were observed. In two instances during Dilapan extraction the rod was disrupted and the residue had to be removed by means of Kocher's forceps. In all patients the dilation of the cervical canal was sufficient for a 6 mm suction curette and further dilation of the cervix by means of metal dilators was not necessary. On examination after menstruation the patients did not report more massive bleeding nor febrile complications or residues. Based on the described results, the authors are of the opinion that gradual dilation of the cervix before abortion in the first trimester should be part of the procedure and all women who must face this situation should be given this opportunity.