Preoperative Administration of Prostaglandin to Avoid Dilatation-Induced Damage in First-Trimester Pregnancy Terminations

Abstract

A prospective, randomized, controlled study was carried out to investigate the dilating and softening effect on the cervix of prostaglandin F2-alpha gel administered intracervically and of prostaglandin E2 tablets administered orally. A total of 581 patients were included in the study: 149 received 2.5 mg prostaglandin F2-alpha in gel form intracervically, 150 received 1 mg prostaglandin E2 in tablet form orally, 138 were given placebo gel and 144 no medication at all. In the groupgiven prostaglandin F2-alphagelintracervically, success was achieved in 85.8% of patients and partial success in 8.8%. In the group given prostaglandin E2 tablets orally, the results were successful in 29.4% and partially successful in 40.6%. The incidence of side effects in the group given prostaglandin F2-alpha gel was rather high – 53%. The results show that prostaglandin can bring about a certain softening of the cervix, but side effects cannot be ruled out. Nevertheless, priming of the cervix is to be recommended in young primigravidas.

Placebo response and effect in randomized clinical trials: meta-research with focus on contextual effects

“…There were 54 trials (total of 5,160 patients) having more than three arms. In 18 of those [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69], one or more additional arms were disregarded (a total of 796 patients) in order to calculate the PCE for groups that had comparable interventions. In the remaining 36 trials with more than three arms, all arms were relevant and therefore included which left a total number of 16,655 patients for the meta-analysis.…”