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Same-Day Compared With Overnight Cervical Preparation Before Dilation and Evacuation Between 16 and 19 6/7 Weeks of
Chi-Son Kim1, Monica Dragoman, Lauren Porsch
1Department of Obstetrics and Gynecology, Stamford Hospital, Stamford, Connecticut; the Division of Family Planning, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, and Planned Parenthood of New York City, New York, and the Department of Obstetrics and Gynecology, NYC Health + Hospitals/Kings County, Brooklyn, New York.
Abstract:
We performed a double-blind, placebo-controlled, randomized noninferiority trial to compare same-day osmotic dilators plus misoprostol with overnight osmotic dilators alone for cervical preparation before dilation and evacuation (D&E) between 16 0/7 and 19 6/7 weeks of gestation. The primary outcome was procedure time. The study was halted early owing to poor accrual. However, the median procedure time was 5.7 minutes in the same-day group compared with 4.2 minutes in the overnight group. The median absolute difference in procedure time was 1.5 minutes, which corresponded to a 35% increase in procedure time (relative difference 35%, one-sided 95% CI -Inf to 52%). Same-day cervical preparation with osmotic dilators plus buccal misoprostol before D&E may be a timely option. Clinical Trial Registration: ClinicalTrials.gov, NCT03002441.
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