Mifepristone vs. osmotic dilator insertion for cervical preparation prior to surgical abortion at 14–16 weeks: a randomized trial

Intrauterine lidocaine for pain control during laminaria insertion: a randomized controlled trial

“…We did note several surprising findings. The mean pain scores associated with laminaria insertion reported in our study are somewhat lower than those seen in prior studies where paracervical block was used [6,7]. Despite the low mean score, we saw a wide range of scores.…”

“…Many women find laminaria placement painful if no anesthesia is used [4,5]; several studies have reported that the procedure may be associated with moderate to severe pain even when cervical or paracervical block is performed [6][7][8]. While multiple studies have evaluated various methods for controlling pain in abortion procedures [9], no studies to date have specifically evaluated different methods of pain control for laminaria insertion.…”

Misoprostol 1 to 3 h preprocedure vs. overnight osmotic dilators prior to early second-trimester surgical abortion

“…That women with one or more prior abortion had longer procedure durations compared to women without a prior abortion may suggest that prior cervical procedures may result in more challenging surgeries. However, prior research has found no association between prior abortion and duration of procedure and this finding may, therefore, be attributed to chance [8]. Finally, although we had no adverse events in our study, our study was not powered for these rare outcomes.…”

“…Protocols for cervical preparation include using osmotic dilators, prostaglandins and/or antiprogestins to reduce the need for additional mechanical dilation that may result in increased risk of cervical trauma and uterine perforation [2][3][4][5][6][7][8].…”

Adjunct mifepristone for cervical preparation prior to dilation and evacuation: a randomized trial

“…One placebo-controlled study by Carbonell et al [22] showed an increase in cervical dilation and a decrease in procedure time when mifepristone was used in addition to osmotic dilators and misoprostol prior to D&E between 12 and 19 weeks of gestational age. A randomized controlled trial by Borgatta et al, comparing mifepristone and misoprostol with osmotic dilators and misoprostol for abortion from 15 to 18 weeks, showed equivalence in procedure time with mifepristone compared to osmotic dilators [23]. These works suggest that mifepristone contributes to the expeditiousness of these procedures by increasing cervical dilation or pliability, or both.…”