Abstract:
OBJECTIVE:To understand effect of adjunct misoprostol on cervical preparation with overnight osmotic dilators for dilation and evacuation after 16 weeks gestation. METHODS:We searched on-line reference databases using search terms for second trimester, abortion, misoprostol, and dilators. Randomized controlled trials of cervical preparation for second trimester D&E using overnight osmotic dilators comparing adjunct misoprostol to placebo were included. Weighted mean with standard deviation (SD) and pooled binary outcomes were compared. RESULTS:Among 84 articles identified, three met inclusion criteria (n = 457 subjects) adjunct misoprostol did not significantly decrease mean procedure times (8.5 ± 4.6 vs 9.6 ± 5.8 min, p = 0.78) or manual dilation (18% vs 28%, p = 0.23) when compared to placebo. There was no difference in total complications (p = 0.61), major complications (p = 0.44), or cervical lacerations (p = 0.87). CONCLUSION:Current limited evidence suggests adjunct misoprostol with osmotic dilators after 16 weeks does not affect procedure time or need for manual dilation. IMPLICATIONS:Further research is needed to determine the effect of adjunct misoprostol on major complications and blood loss.
journal_name
Contraceptionjournal_title
Contraceptionauthors
Cahill EP,Henkel A,Shaw JG,Shaw KAdoi
10.1016/j.contraception.2019.09.005subject
Has Abstractpub_date
2020-02-01 00:00:00pages
74-78issue
2eissn
0010-7824issn
1879-0518pii
S0010-7824(19)30429-9journal_volume
101pub_type
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