Related Experiment Video
Updated: Aug 14, 2026
07:41
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Sonographic cervical changes induced by Dilapan-S: a prospective observational study
Martina Derme1, Cristina Pajno1, Gabriele Vella Bianchi1
1Università Sapienza Roma, Department of Mother and Child Health and Urological Sciences Policlinico Umberto 1, Italy.
Summary
Dilapan-S (DS) use during cervical ripening leads to measurable sonographic changes. Shorter cervical length (CL) after DS removal is linked to higher rates of vaginal birth and shorter labor induction-to-delivery times.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Medicine
- Medical Imaging
Background:
- Cervical ripening is crucial for labor induction in term pregnancies with unfavorable cervices.
- Dilapan-S (DS) is a device used for mechanical cervical ripening.
- Sonographic assessment can quantify cervical changes during ripening.
Purpose of the Study:
- To document sonographic cervical changes induced by Dilapan-S (DS) during cervical ripening at term.
- To investigate the association between these sonographic changes and the mode of birth.
Main Methods:
- Prospective observational study of singleton pregnancies undergoing labor induction at term (>37 weeks) with an unfavorable cervix (Bishop score ≤4).
- DS was inserted for 12-16 hours.
- Ultrasonography measured cervical length (CL), posterior cervical angle (PCA), and fetal occiput position before DS insertion and at removal.
- Primary outcome: mode of birth (vaginal vs. cesarean delivery).
Main Results:
- Of 37 women, 75.7% had a vaginal birth.
- All cervical sonographic parameters changed significantly post-DS insertion, but fetal head position did not.
- Shorter CL at DS removal was associated with vaginal birth (21.3 vs. 26 mm; p=0.047) and correlated with a shorter induction-to-delivery interval (r=0.604; p=0.0006).
- Cervical length at DS removal remained significantly associated with vaginal delivery in multivariable analysis (aOR 0.919; p=0.032).
Conclusions:
- Dilapan-S (DS) induces significant sonographic changes in cervical length and posterior cervical angle.
- A shorter cervical length (CL) at DS removal is associated with vaginal birth and a shorter induction-to-delivery interval.
- These findings require confirmation in larger studies.
