Related Experiment Video
Updated: Jun 14, 2026
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Cervical preparation prior to dilation and evacuation between 13 and 16 weeks gestation
Lillian C Chen1, Guillaume Stoffels2, Kelly Wang2
1Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
Objective:
Compare differences in dilation and evacuation (D&E) outcomes after single-agent cervical preparation.
Study Design:
We conducted a retrospective cohort study of patients receiving buccal misoprostol, oral mifepristone, or osmotic dilators prior to D&E between 13 and 16 weeks gestation. The primary outcome was procedure time and secondary outcomes were procedure complications.
Results:
From 277 D&E cases, there was no significant difference in adjusted procedure time (p = 0.11). Mifepristone was associated with a lower estimated blood loss (EBL) after adjusting for gestational age, however, this difference may not be clinically significant. There were few procedure complications across all methods of cervical preparation.
Conclusions:
All 3 methods of cervical preparation were associated with short procedure times and few complications. Selection of the cervical preparation method can be individualized to patient preferences and individual needs.
Implications:
There is currently no standardized recommendation for cervical preparation prior to D&E in the late first and early second trimesters; our findings demonstrate short procedure times and few complications for all methods of cervical preparation for D&E between 13 and 16 weeks gestation.
