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pubmed:otherAbstract |
PIP: A Foley catheter with the balloon inflated above the internal cervical os, and a 3 mg dinoprostone pessary (Prostin E2) were compared for cervical dilatation before early second trimester dilatation and evacuation. Experimental subjects were 21 women given PGE2 and 23 having catheters, comprising all women between 12-16 weeks' gestation presenting consecutively for termination, allocated at random. Cervical preparation was done after an antiseptic swab, 24 hours before surgery. The size 14-Foley catheter was inserted 3-4 cm into the cervix and inflated with 25 ml water; the pessary was inserted into the posterior fornix. Under general anesthesia, dilatation, measured using largest dilators 1st, averaged 10.4 mm compared to 3.2 mm before treatment in the catheter group, but 8.7 in the PG group compared to 3.7. The increase in dilatation was 7.2 mm in the catheter group, and 5.0 in the PG group (p0.003). Cervical compliance, estimated on a scale of 1-5 by the surgeon, averaged 4.4 in the catheter group, and 2.8 in the PG group (p,0.001). 4 women complained of pain after catheters, 1 after PG. There was 1 case of cervical tear and rigid cervix, requiring hysterotomy. In this protocol, the Foley catheter seems to be the most efficient means of dilating the cervix.
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