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Prospective Comparison of Dilapan and Laminaria for Pretreatment of the Cervix in Second-Trimester Induction Abortion

Fifty-four women presenting for second-trimester induction abortion received either Dilapan synthetic dilators or laminaria for pretreatment of the cervix before induction abortion using intra-amniotic prostaglandin (FG) F2α. The two groups were similar with respect to age, parity, previous abortion, and gestational age. Neither group experienced any unusual complications. The same protocol for intraamniotic PGF2α (40 mg) was used in all patients except for three with histories of asthma, in whom PGE2 vaginal suppositories (20 mg) were used as the induction agent. For the Dilapan group, an average of three devices was used, compared with an average of six in the laminaria group. The mean (± SEM) induction-abortion time for Dilapan patients was 10.9 ± 1.3 hours, compared with 16.1 ± 1.4 hours in the laminaria group, a statistically significant difference (P <.05). When nulliparous women were examined separately, the mean times were 11.0 ± 1.7 for Dilapan and 16.5 ± 1.6 for laminaria, a medically relevant and statistically significant difference (P <.05). Dilapan appears to be an effective alternative to laminaria that results in shorter induction abortion intervals.