The Time Point of Carboprost Methylate Administration and Perioperative Complications
Status:
Completed
Trial end date:
2023-03-31
Target enrollment:
Participant gender:
Summary
Artificial abortion is the most widely used procedure in termination of first-trimester
pregnancy. Cervical ripening before the operation guarantees operative convenience and
decreases complications. An overstrained cervical dilation associates with uterine
perforation, cervical laceration and cervical incompetence. To address the issue, various
mechanical and pharmaceutical methods have been applied to prepare the cervix before
transvaginal procedures. Prostaglandin analogues (PGs) play an important role in ripening the
cervix or promoting uterine contraction in gynecology and obstetrics. As most tissues express
prostaglandin receptors, vomiting, nausea, fever, diarrhea and abdominal pain can hardly be
avoided with PGs administration. Longer PGs action contributes to better cervical ripening,
but more uncomfortableness at the same time. These annoying symptoms may affect the
participants' satisfaction and increase perioperative risks. To balance the safety and
effectiveness of the surgery as well as patients' feeling, a proper timing for cervical
ripening should be investigated. However, the administration timing of PGs has not reached a
broad consensus, ranging from 16 hours to 2 hours before surgery. Carboprost methylate (CM),
a PG-F2α analogue, has been used nationwide for cervical ripening in China. To minimize the
side effects of PGs without affecting cervical ripening, the investigators intended to
explore shortening the action time of CM in cervical preparation before artificial abortion.
Thus, the investigators conducted this prospective cohort study and aimed to examine the
efficacy of early and delayed vaginal administration of CM before surgery, and optimized both
the perioperative safety and participants' convenience. The investigators hypothesize that
early vaginal administration of CM would not affect the cervical ripening status, but will
greatly reduce the unpleasant complications among the participants.