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  • Title: A comparison of gemeprost (Cervagem) pessaries and Lamicel tents for cervical preparation for abortion by dilatation and suction.
    Author: Helm CW, Davies N, Beard RJ.
    Journal: Br J Obstet Gynaecol; 1988 Sep; 95(9):911-5. PubMed ID: 3056505.
    Abstract:
    In a randomized, single-blind trial, 78 women having vaginal termination of pregnancy were treated with either a 1-mg gemeprost (Cervagem) pessary or a Lamicel tent inserted 3-4 h before operation. Both agents produced satisfactory cervical softening but dilatation was significantly easier after gemeprost. Pre-operative side-effects were more frequent after gemeprost but did not increase the need for analgesia. There were no differences between the two groups with regard to either postoperative symptoms and analgesic requirements or pre-operative and postoperative temperature, pulse rate and blood pressure. Gemeprost pessaries are easier, faster and less uncomfortable to administer. In a clinical trial, a physician treated 78 women having an abortion with either a Lamicel tent or a 1 mg gemeprost (Cervagem) pessary 3-4 hours before surgery. Researchers matched the women to age, parity, gestational age, and previous uterocervical surgery. The physician or the assistant chose the specific treatment in strict numerical order from randomly ordered sealed envelopes. Prior to surgery, an assistant used a speculum to empty the vagina of all traces of the Lamicel tent or the gemeprost pessary. Therefore each surgeon remained "blind" to the treatment used to dilate the cervix. Even though there was no significant difference in the blood and fluid loss between the 2 groups (t = .67; p = .5), both surgeons did observe a greater resistance of cervices to dilate after Lamicel than after gemeprost (p .001). Patients who received gemeprost experienced more adverse effects preoperatively, especially abdominal pain (74%) and bleeding (18%), than did those who were treated with Lamicel (50%. and 7.5% respectively). Despite a higher percentage of women experiencing side effects with gemeprost, there was not a corresponding increased need to administer analgesia. Postoperative side effects were similar in both the gemeprost and Lamicel groups. Additionally, no significant differences existed between the 2 groups in regards to postoperative analgesic requirements or preoperative and postoperative temperature, pulse rate, and blood pressure. Notwithstanding the side effects of gemeprost, it was more effective in dilating the cervix, easier to insert, and less uncomfortable than Lamicel.
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