Analysis of cervical resistance during continuous controllable balloon dilatation
Petar Arsenijevic, Slobodan Arsenijevic, Aleksandar Zivanovic, Slavica Djukic Dejanovic
Faculty of medical sciences, Kragujevac, Serbia
Background: Hydraulic dilatation is a novel method of cervical dilatation that is based on continuous and controllable dilatation by the pumping of fluid into the balloon extension of the system for continuous and controllable balloon dilatation (CCBD). The main advantage of this procedure is that it allows control and insight into the process of cervical dilatation.
Methods: For the purposes of our research, we created a new and upgraded system for continuous and controllable balloon dilatation (CCBD), which consists of a programmed hydrostatic pump connected to a balloon extension. With regards to our aim to precisely measure and determine the location of the cervical resistance, we placed two pressure-measuring films on the top and on the bottom of the balloon extension. This study included 42 women in whom cervical resistance was measured prior to the suction curettage.
Results: Cervical dilatation and measurement of cervical resistance were successful in all women. The analysis of the pressure-measuring films showed that the points of highest resistance are located in the zone of the internal cervical os and that these values are much higher than those in the zone of the external cervical os (0.402 versus 0.264 MPa at the upper pressure-sensitive film; 0.387 versus 0.243 MPa at the lower pressure-sensitive film). This study also showed that an increase in cervical resistance in the zone of the internal cervical os was followed by an increase in cervical resistance in the zone of the external cervical os.
Conclusion: During continuous controllable balloon dilatation, the internal cervical os is the centre of cervical resistance, and the values do not decline with the number of miscarriages or the number of previous births.