Cervical dilation: A comparison of Lamicel and Dilapan

Wells, Ellen C.; Hulka, Jaroslav F.

doi:10.1016/0002-9378(89)90647-9

Cited by 19 publications

(6 citation statements)

References 4 publications

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“…Various methods of preparing the cervix have been used in an attempt to reduce the risk of uterine and cervical damage. Laminaria tents have been used but have the disadvantage of being of biological origin (dried seaweed) that is difficult to sterilise 2 . Such tents have been associated with an increased risk of infection.…”

Section: Introductionmentioning

confidence: 99%

Audit of the effectiveness of cervical preparation with Dilapan prior to late second‐trimester (20–24 weeks) surgical termination of pregnancy

Poon

Parsons

2007

BJOG

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The aim of this audit was to evaluate the efficacy of cervical preparation with Dilapan dilators prior to late second-trimester surgical termination of pregnancy. The first audit cycle showed that after cervical preparation consisting of one or two Dilapan dilators, with or without misoprostol, on the day before or the day of the procedure, there were nine cases of cervical and uterine damage. The second audit cycle showed that cervical preparation, which consisted of two or three Dilapan dilators, on the day before the procedure improves cervical preparation and reduces the risk of damage to the uterus and cervix.

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Section: Introductionmentioning

confidence: 99%

Audit of the effectiveness of cervical preparation with Dilapan prior to late second‐trimester (20–24 weeks) surgical termination of pregnancy

Poon

Parsons

2007

BJOG

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“…The second type of device, e.g. Dilapan, is a synthetic hygroscopic polyacrylonitrile (hypan plastic polymer) rodshaped dilator, acting primarily mechanically and having a notable clinical effect within 2-4 h [18]. The third type is Lamicel, a sterile, polyvinyl sponge impregnated with magnesium sulphate, which can reversibly decouple collagen cross-linkages in cervical stroma and increase sensitivity to prostaglandin E 2 [19].…”

Section: Discussionmentioning

confidence: 99%

“…The predominant chemical action with no outward pressure on the cervical wall permits it to be placed into a narrow, stenotic cervix and swell with a minor hourglass effect [20]. These osmotic dilators have been used to ripen the cervix for induced abortion as well as to overcome stenosis in non-pregnant women requiring hysteroscopy [13][14][15][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

A prospective, randomized, controlled trial comparing vaginal misoprostol and osmotic dilator in achieving cervical ripening before operative hysteroscopy

Xia

et al. 2006

Gynecol Surg

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A prospective, randomized, controlled trial comparing vaginal misoprostol and osmotic dilator in achieving cervical ripening before operative hysteroscopy Abstract The purpose of this study was to compare the effectiveness of vaginal misoprostol and an osmotic dilator in achieving cervical ripening before operative hysteroscopy in pre-menopausal women. One hundred patients undergoing operative hysteroscopies with a 9-mm hysteroscope were prospectively and randomly assigned to two groups. In group 1 (the misoprostol group), 53 patients received 400 μg of vaginal misoprostol 12 h before the operation. In group 2 (the osmotic dilator group), 47 patients had an osmotic dilator inserted into the cervical canal 12 h before the operation. The primary outcome measure in this study was cervical width, assessed by the largest number of Hegar dilators that could be inserted into the cervix without resistance. The secondary outcome measure was the subjective assessments of the ease of dilatation to 9 mm by the surgeon. Adverse effects experienced including preoperative pain and vaginal bleeding were recorded for each group. There was no difference between the two groups with regard to demographic variables. The spontaneous cervical dilatation (mean ± SD) in the osmotic dilator group (9.6±2.2 cm) was significantly (P<0.01) greater than that in the misoprostol group (8.0±1.8 cm). In addition, the proportion of difficult dilatation in the osmotic dilator group (8 out of 47, 17.0%) was significantly less than that in the misoprostol group (22 out of 53, 41.5%). The occurrence of vaginal bleeding in the misoprostol group (77.4%) was significantly (P<0.01) higher than that in the osmotic dilator group (31.9%). The osmotic dilator is more effective than misoprostol at achieving cervix ripening prior to operative hysteroscopy.

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“…A single Lamicel can provide effective dilation when placed a few hours preoperatively up to 16 weeks, and with overnight placement for gestations up to 17 weeks. 18 The length of time that osmotic dilators should be left in situ depends on the dilator chosen and the degree of dilation www.clinicalobgyn.com required. Overnight dilation is not required in early second-trimester procedures.…”

Section: Using Osmotic Dilatorsmentioning

confidence: 99%

Cervical Dilation in Second-Trimester Abortion

Hayes¹,

Fox²

2009

Clinical Obstetrics &Amp; Gynecology

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Dilation and evacuation, the most common method performed for second-trimester abortion in the United States, requires sufficient cervical dilation to reduce the risk of complications such as cervical laceration or uterine perforation. The cervix may be prepared with osmotic dilators such as laminaria, Lamicel, or Dilapan-S, or with pharmacologic agents such as misoprostol. Dilapan-S and Lamicel achieve their maximum dilation faster than laminaria, making same-day procedures possible. Misoprostol has limited data supporting its use in this setting. Decisions regarding which method is best are clinician-dependent, and factors such as gestational age and time allowed for preparation should be considered.

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Cervical dilation: A comparison of Lamicel and Dilapan

Cited by 19 publications

References 4 publications

Audit of the effectiveness of cervical preparation with Dilapan prior to late second‐trimester (20–24 weeks) surgical termination of pregnancy

Audit of the effectiveness of cervical preparation with Dilapan prior to late second‐trimester (20–24 weeks) surgical termination of pregnancy

A prospective, randomized, controlled trial comparing vaginal misoprostol and osmotic dilator in achieving cervical ripening before operative hysteroscopy

Cervical Dilation in Second-Trimester Abortion

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