EFFECTS OF GEMEPROST AND MIFEPRISTONE ON THE MECHANICAL-PROPERTIES OF THE CERVIX PRIOR TO FIRST TRIMESTER TERMINATION OF PREGNANCY

Objective To study the effects of oral mifepristone and vaginal gemeprost on the mechanical properties of the cervix prior to first trimester termination of pregnancy by vacuum aspiration. Design A comparative study. Each patient served as her own control. Setting The Royal Infirmary of Edinburgh, Scotland, UK. Subjects Forty nulliparous women at six to twelve weeks of pregnancy. Interventions The women received either gemeprost (1 mg) 3 h prior to termination of pregnancy or mifepristone (200 mg) 48 h before operation. Main outcome measures Two different objective methods of assessment of the mechanical properties of the cervix, one measuring the distensibility of the cervix before drug administration and immediately before the operation, and the other measuring the force necessary to dilate the cervix; incidence of new symptoms following drug intake; immediate complications and estimated blood loss. Results Both treatments significantly increased cervical distensibility. Baseline dilatation was greater in the mifepristone group. The force required to dilate the cervix was significantly reduced in mifepristone-treated patients. There was a good correlation between the two different methods of assessment of the mechanical properties of the cervix only in the gemeprost group. Conclusion Cervagem and mifepristone can be used to increase cervical distensibility. Cervical dilatation is easier with a 48 h regimen of mifepristone than with gemeprost.