VAGINAL DINOPROSTONE VERSUS ORAL MISOPROSTOL FOR PREDILATATION OF THECERVIX IN FIRST-TRIMESTER SURGICAL ABORTION

Prostaglandins are effective in predilatation of the cervix prior to f irst trimester surgical termination of pregnancy under local analgesia , A randomized open comparative trial was devised to compare the effec tiveness and acceptability of vaginal dinoprostone with oral misoprost ol. Two groups were randomized to control for age, parity and ethnicit y. The operation was easier and less painful in older, parous, and Pol ynesian women. Both methods were effective with respect to ease of dil atation. Both were acceptable and equal with respect to the level of p ain experienced by the woman during the operation. Vaginal dinoproston e is more gradual in its action, but it is more expensive, has to be r efrigerated and self-insertion may sometimes cause problems. Oral miso prostol is considerably cheaper and does not require refrigeration, bu t it was associated with more preoperative nausea, cramping and occasi onal heavy bleeding.