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Cervical Dilation in Second-Trimester Abortion

HAYES, JENNIFER L. MD, MPH*; FOX, MICHELLE C. MD, MPH

Clinical Obstetrics & Gynecology: June 2009 - Volume 52 - Issue 2 - pp 171-178
doi: 10.1097/GRF.0b013e3181a2b3cd
Pregnancy Termination

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.

*Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburg, Pennsylvania

Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Maryland

Funding Disclosures: None.

Correspondence: Jennifer L. Hayes, MD, MPH, Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Hospital, University of Pittsburg, Pittsburg, PA 15213. E-mail: jhayes@mail.magee.edu

© 2009 Lippincott Williams & Wilkins, Inc.