Abstract
Author(s): Tarek Hesham EL-Sayed, Ayman Abdelrazek Abulnour, Aya Mohamed Mohamed Abdelsalam* and Heba Aallam Abdelbasset
Background: Mid-trimester abortions account for 10% to 15% of all abortions but account for two-thirds of all serious complications. In the second trimester, termination of pregnancy can be achievied by induction of abortion, D&E, hysterotomy, and hysterectomy. Cervical laceration and uterine perforation are reduced when the cervix is prepared prior to surgery. Osmotic dilators can be used to prepare the cervix.
Aim of the work: The aim of the study is to compare the effectiveness of Dilapan-s vs. misoprostol as a cervical ripening agent in second trimester abortions between 13 and 18 weeks of gestation.
Patients & Methods: This prospective, randomized comparative clinical trial was conducted at tertiary care hospital at Ain Shams University Maternity hospital, labor ward from June 2020 till August 2021 and performed on total 56 women with previous one cesarean section with second trimester abortion between 13 and 18 weeks of gestation fulfilling the study?s eligibility criteria.
Results: Time interval from start of procedure to the start of expulsion and complete expulsion of fetus statistically was non-significantly shorter among Dilapan group than among Misoprostol group (p value=0.397, 0.105 respectively). There was no significant statistical difference between the study groups regarding successful abortion and need for surgical evacuation (p value=0.567, 0.149 respectively), with no statistically significant complications (nausea, vomiting, fever rupture uterus and post-abortive bleeding) between the study groups. The Hospital stay duration statistically was non-significantly different among the studied groups (p value=0.341). The Pain experienced was statistically non-significantly different among the studied groups (p value=0.106) and all the studied cases of both groups needed analgesics.
Conclusion: Dilapan is an insignificant agent for cervical ripening prior to abortion induction when compared to misoprostol.