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Updated: May 24, 2025
08:49
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
14.4K
Cervical preparation for dilation and evacuation at 12 to 24 weeks gestation
Tesfaye H Tufa1, Fiona Stewart2, Karen Meckstroth3
1Department of Obstetrics & Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
The Cochrane Database of Systematic Reviews
|March 3, 2025
Summary
This review found that misoprostol and mifepristone, when used with osmotic dilators, likely improve cervical dilation and reduce procedure time for second-trimester abortions. Further research is recommended for patient satisfaction.
Area of Science:
- Reproductive Medicine
- Gynecologic Surgery
- Evidence-Based Medicine
Background:
- Complications in abortion increase with gestational age.
- Cervical preparation is recommended for second-trimester surgical abortion.
- Optimal cervical preparation methods require further evidence.
Purpose of the Study:
- To assess the effectiveness of various cervical preparation methods.
- Focus on second-trimester surgical abortion (12-24 weeks gestation).
Main Methods:
- Systematic review of randomized controlled trials (RCTs).
- Searched multiple databases up to December 2021.
- Included 21 RCTs with 3029 participants.
Main Results:
- Misoprostol plus osmotic dilators likely increase dilation and reduce procedure time compared to placebo.
- Mifepristone plus osmotic dilators may reduce procedure time and increase dilation.
- Overnight laminaria may be more effective than same-day Dilapan-S for dilation and procedure time.
Conclusions:
- Pharmacological agents like misoprostol and mifepristone, combined with osmotic dilators, appear beneficial for cervical preparation.
- Overnight laminaria shows potential advantages over same-day osmotic dilators.
- Further research is needed on patient and provider satisfaction.
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