| Abstract: | Direct dilatation of the cervix and surgical evacuation of the uterus is gaining in popularity as a 2nd-trimester method of induced abortion as technical skills improve. Cervical resistance, however, is an important complicating factor in 2nd-trimester procedures. There is general debate concerning the safest and most effective means of effecting nontraumatic dilatation of the cervix. The disadvantages of laminaria tents and metal dilators are cited. It is important to avoid trauma to the cervix which might lead, especially in primiparous women, to future cervico-vaginal fistulae, endangering future fertility. A new dilating device is described and diagrammed. The device combines an accurate, monitored hydrostatic dilatation at the inner os with administration of low dosages of abortifacients into the extra-amniotic space. The device has the advantages of being less traumatic to the cervix, reducing hospital inpatient time, and reducing blood loss at the time of the procedure. The device could be used by nonmedical personnel with little additional training, which would make it useful for developing countries. |
