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  • Title: Cervical treatment with Dilapan prior to second trimester dilation and evacuation abortion: a pilot study of 64 patients.
    Author: Hern WM.
    Journal: Am J Gynecol Health; 1993; 7(1):23-6. PubMed ID: 12345302.
    Abstract:
    A trial of the synthetic hygroscopic cervical dilator Dilapan (Gynotech Inc.) in 64 women having 2nd trimester dilation and evacuation abortion is reported. The women were clients of an outpatient abortion clinic in Boulder, Colorado, from December 1985 to February 1986. Their gestational ages were 13-25 weeks, their ages 15-41 years, and 59% were nulliparas. They had 1-5 Dilapan dilators, dipped in nitroufurazone ointment, placed intracervically the day before the procedure after preparation of the cervix with povidone-iodine solution. The number of dilators was that which could be inserted easily. 14% received 1 dilator, 64% had 2 dilators, 22% had 3, and 1 woman had 4. 3 women had the dilators removed and replaced 6 hours later because of discomfort. Women who were over 20 weeks' pregnant received urea intraamniotically. Dilapan dilators were left in place from 6-30 hours. Before abortion adequate cervical dilation was obtained manually as needed. The length of the abortion procedure ranged from 2-22 minutes and was proportional to gestational length. Blood loss averaged 118 ml (range 5-500 ml), also related to gestation. The number of dilators placed was not correlated with length of the procedure or blood loss. There were several minor complications related to the Dilapan dilators: disintegration of the dilators in 2 women, retraction into the internal os, expulsion of the dilators, rupture of membranes during insertion, "dumbelling" of the dilators, and 15 cases of inadequate dilation after one dilator. Several women had cramping, felt to be due to the rapid expansion of these synthetic dilators. Despite these problems, Dilapan dilators were considered safe.
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