Cervagem/Dilapan for preoperative cervical dilatation prior to vacuum aspiration for termination of first trimester pregnancy. A prospective randomized study.

The present study included 40 healthy nulliparous women admitted to the hospital for termination of first trimester pregnancy. The patients were randomly allocated to two study groups. One group was treated for 4 hours with one 1 mg Cervagem vaginal suppository prior to vacuum aspiration, the other was treated 4 hours with a Dilapan osmotic dilator intracervically. The patients were continuously supervised during treatment and after operation. Side effects and analgesic consumption were recorded. At operation the degree of cervical dilatation, blood loss and operative complications was registered. Dilapan was more effective and more uniform in dilating the cervix (p less than 0.05) and eventual further dilatation was easier (p less than 0.05). The blood loss was higher in the Dilapan-treated group (p less than 0.05). Side effects of postoperative pain and use of analgesic injections were higher in the Cervagem group (p less than 0.05). It is concluded that both methods are effective in dilating the cervix prior to vacuum aspiration, with Dilapan being the more effective dilator with the lower frequency of side effects.