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Comparison of Dilapan-S and laminaria for cervical priming before surgical pregnancy termination at 17–22 weeks' gestation

2011; Dove Medical Press; Linguagem: Inglês

10.2147/ijwh.s25551

1179-1411

Dennis G. Chambers, Willcourt, Laver, Donna D. Baird, Herbert,

Assisted Reproductive Technology and Twin Pregnancy

A retrospective analysis of medical records of three consecutive cohorts of women. All cohorts received a digoxin feticide injection on Day 1. Two cohorts were treated with laminaria, cohort A of 151 women over 1-2 days and cohort B of 52 women over 1-3 days, and cohort C of 151 women was treated with Dilapan-S over 1-3 days.Adequate cervical priming for dilatation and evacuation (D&E) on Day 2 was achieved in 98% of the Dilapan-S cohort and 56% of cohort A and 40% of the cohort B laminaria cohorts. Return to theater for D&E 3-4 hours after dilator insertion on Day 2 occurred in 62.3% of Dilapan-S cohort C and 9.3% of cohort A and 4% of cohort B laminaria cohorts (P = 0.001). A mean D&E theater time of 19 minutes for laminaria cohort A was reduced by 10.1% in the Dilapan-S cohort C (P = 0.02). The incidence of unscheduled overnight delivery outside the clinic was 0% for Dilapan-S and 1.3% for cohort A and 3.8% for cohort B laminaria cohorts (P = 0.14).Dilapan-S osmotic dilators are superior to laminaria in producing more cervical priming and dilatation in a shorter time. This enables 17-22 week D&E procedures to be carried out in fewer days and in shorter theater times. They also eliminate the risk of an unscheduled overnight delivery outside the clinic.