CHANGES IN THE CELOMIC FLUID COMPOSITION FOLLOWING 2 DIFFERENT METHODS OF CERVICAL RIPENING

We have evaluated the changes in maternal serum and coelomic fluid bio chemical composition following two different methods of cervical ripen ing, i.e. mechanical and biochemical, Each study group included 20 wom en between 8 and 12 weeks of gestation who were requesting termination for psychosocial reasons, In the first group, a 3 mm hypan (synthetic hygroscopic dilator) was inserted into the cenix 12 h preoperatively, In the second group, two 1 mg pessaries of gemeprost (prostaglandin a nalogue) were inserted into the posterior fornix 6 and 2 h preoperativ ely, Coelomic fluid and maternal serum were obtained at the time of th e surgical procedure and assayed for urea, total protein, potassium, s odium, human chorionic gonadotrophin (HCG) and alpha-fetoprotein (AFP) , Significantly higher coelomic fluid sodium (t = 4.72; P = 0.029) and significantly higher maternal serum AFP (t = 13.21; P < 0.001) concen trations were observed after gemeprost than after hypan, There was no difference in the concentration of potassium, urea, total protein and HCG between the two groups, These findings indicate that prostaglandin analogues, when used for cervical ripening, provoke a breakdown of th e placental barrier resulting in an increase in AFP molecules transfer red from the fetal fluid compartments into the maternal circulation, T he results also suggest that these drugs increase the placental permea bility to sodium with a secondary accumulation of this ion in the coel omic fluid.