In a randomized, double-blind study, 30 healthy, nulliparous women of similar gestational age were given intracervical applications of 0.5mg
PGE2, 0.05mg
Sulprostone or 0.1mg
Sulprostone gel in order to soften the cervix prior to
curettage for first trimester termination of pregnancy. The preparations were administered 8 hours before
curettage. The number of complete and
incomplete abortions, ease of passage through the cervical canal, as measured by a tonometer before and 8 hours after the administration of
prostaglandin, the degree of
pain experienced and the quantity of
analgesics required, plus the frequency of systemic side effects were all always assessed by one trialist. With regard to the rate of abortion and cervical softening, the administration of 0.1mg
Sulprostone gel proved the most effective method. However, in comparison with the others, it also caused the greatest degree of
pain and necessitated the greatest use of
analgesics. The softening effect of the
prostaglandin E2 gel was significantly less and in this group there were two cases of cervical lesion due to tenaculum
laceration. The intracervical application of 0.05mg
Sulprostone gel is to be recommended for pre-operative ripening of the cervix before termination of pregnancy in the first trimester, as it effectively dilates the cervix and does not cause systemic side effects or
pain in the lower abdomen, enough to make treatment necessary.