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Adjunctive Agents for Cervical Preparation in Second Trimester Surgical Abortion
Jessika A Ralph1, Lee P Shulman2,3
1Section of Family Planning, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Advances in Therapy
|April 21, 2019
Summary
Shortening cervical preparation for late second-trimester surgical abortion is possible. Using medications like mifepristone and misoprostol with osmotic dilators significantly reduces preparation time for dilation and evacuation procedures.
Area of Science:
- Medical Sciences
- Surgical Procedures
- Reproductive Health
Background:
- Late second-trimester surgical abortion requires significant cervical dilation.
- Traditional cervical preparation with osmotic dilators takes multiple days.
- There is a need to shorten cervical preparation time.
Purpose of the Study:
- To review evidence on adjunctive agents for cervical preparation in late second-trimester abortion.
- To evaluate the efficacy of mifepristone and misoprostol in reducing cervical preparation time.
Main Methods:
- Review of current scientific literature on cervical preparation methods.
- Analysis of studies using osmotic dilators with and without adjuvant medications.
- Focus on procedures above 19 weeks gestation.
Main Results:
- Adjunctive mifepristone and misoprostol, combined with osmotic dilators, achieve adequate cervical dilation faster than dilators alone.
- These medications facilitate cervical preparation in less than 24 hours.
Conclusions:
- For surgical abortion care above 19 weeks gestation, consider mifepristone and/or misoprostol alongside osmotic dilators.
- Adjunctive medications are effective in shortening cervical preparation time for dilation and evacuation.
- This approach can improve efficiency in late second-trimester abortion procedures.
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