Journal
CLINICAL OBSTETRICS AND GYNECOLOGY
Volume 52, Issue 2, Pages 171-178Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/GRF.0b013e3181a2b3cd
Keywords
dilation; evacuation; osmotic dilator; pharmacologic agents
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Dilation and evacuation, the most common method performed for second-trimester abortion in the United States, requires Sufficient cervical dilation to reduce the risk of complications such as cervical laceration or uterine perforation. The cervix may be prepared with osmotic dilators such as laminaria, Lamicel, or Dilapan-S, or with pharmacologic agents such as misoprostol. Dilapan-S and Lamicel achieve their maximum dilation faster than laminaria, making same-day procedures possible. Misoprostol has limited data supporting its use in this setting. Decisions regarding which method is best are clinician-dependent, and factors Such as gestational age and time allowed for preparation should be considered.
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