Longitudinal ultrasound evaluation of Dilapan-S diameter during cervical ripening

Seagraves, Elizabeth; Waller, Jerri A.; DeYoung, Tracey; Barake, Carole; Kawakita, Tetsuya; Kanaan, Camille; Abuhamad, Alfred

doi:10.1016/j.ajog.2021.11.1034

Cited by 2 publications

(1 citation statement)

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“…Experimental and clinical studies have shown that Dilapan-S is superior to laminaria regarding the degree and speed of cervical dilatation associated with shorter induction-to-delivery intervals [11,12,13]. The thin rod (4 mm) can expand up to 12 mm over a 12 hours period and 92% dilatation was reached within 8 hours, as recently shown in vivo in the USE Dilapan Ultrasound study [14].…”

Section: Introductionmentioning

confidence: 73%

Synthetic Osmotic Dilators for Pre-Induction Cervical Ripening – an Evidence-Based Review

Rath

Kummer

Königbauer

et al. 2023

Geburtshilfe Frauenheilkd

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Mechanical methods have gained growing interest for pre-induction cervical ripening in women with an unripe cervix, since they have a better safety profile compared to prostaglandins. Balloon catheters have been the gold standard method for decades, while there was a lack of data on synthetic osmotic cervical dilators.Not until 2015, when Dilapan-S was approved by the Food and Drug Administration (FDA) for induction of labor, numerous studies have been published on the use of Dilapan-S in this field. The rate of vaginal deliveries associated with the use of Dilapan-S ranges from 61.6 to 81.7%, and no serious complications needing further interventions have been reported to this date.Dilapan-S was shown to be as effective as the Foley balloon catheter as well as the 10 mg PGE2 vaginal insert and orally applied misoprostol (25 µg every 2 hours) in achieving vaginal delivery, but patient’s satisfaction during the cervical ripening process was significantly higher compared to the other methods and the rate of uterine hyperstimulation was significantly lower compared to prostaglandins (PGs).Minor complications (e.g. vaginal bleeding) associated with the use of Dilapan-S were < 2%, and maternal infectious morbidity was not higher compared to Foley balloon and vaginal PGE2 or misoprostol.Due to these beneficial properties Dilapan-S might be an ideal option for outpatient cervical ripening, as shown in a recent randomized clinical trial comparing inpatient to outpatient cervical ripening.Furthermore, according to the manufacturers’ product information, Dilapan-S is the only cervical ripening method that is not contraindicated for induction of labor in women with a previous cesarean section. Upcoming guidelines should consider synthetic osmotic cervical dilators as an effective and safe method for cervical ripening/induction of labor acknowledging that more evidence-based data are mandatory, particularly in patients with a previous cesarean section.

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Section: Introductionmentioning

confidence: 73%

Synthetic Osmotic Dilators for Pre-Induction Cervical Ripening – an Evidence-Based Review

Rath

Kummer

Königbauer

et al. 2023

Geburtshilfe Frauenheilkd

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Cervical Preparation for Hysteroscopy Using Dilapan-S Three Hours before Surgery: A Randomized Controlled Trial

Shahriyaripour,

Chaichian,

Tahermanesh

et al. 2024

Clin. Exp. Obstet. Gynecol.

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Background: Hysteroscopy is a pragmatic diagnostic and operative method for the assessment of uterine pathologies. Cervical preparation is an important step for hysteroscopy, and it is recommended in order to reduce complications. The efficacy of Dilapan-S and Misoprostol as two means of cervical preparation were evaluated and compared in this study. Methods: This randomized clinical trial was conducted on women referred to Rasoul-e-Akram Hospital outpatient department. A total of 120 menopausal and non-menopausal patients with no history of vaginal delivery were included in this study. 400 micrograms of misoprostol and Dilapan-S were used for cervical ripening three hours before hysteroscopy. Cervical dilation was measured by the diameter of the largest dilator inserted without resistance prior to hysteroscopy. The time needed to achieve 9 mm dilatation was recorded. Complications of the procedure were evaluated and compared in both groups. Results: The size of the largest Hegar dilator without resistance in Dilapan-S and misoprostol groups were 7.6 ± 0.86 mm and 6.05 ± 1.04 mm, respectively (p < 0.0001). Preoperative complications including headache and nausea were significantly higher in misoprostol group (p = 0.013). Applying Dilapan-S for cervical ripening significantly reduced the time of cervical dilation (p < 0.0001). Conclusions: Short-term application of Dilapan-S before surgery, due to proper preparation of the cervix, increases the chance of successful hysteroscopy, without causing intolerance or major complications in patients or necessitating a longer preoperative hospital. Clinical Trial Registration: the study was registered at https://en.irct.ir/ (registration number IRCT20191123045476N2).

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Longitudinal ultrasound evaluation of Dilapan-S diameter during cervical ripening

Cited by 2 publications

References 0 publications

Synthetic Osmotic Dilators for Pre-Induction Cervical Ripening – an Evidence-Based Review

Synthetic Osmotic Dilators for Pre-Induction Cervical Ripening – an Evidence-Based Review

Cervical Preparation for Hysteroscopy Using Dilapan-S Three Hours before Surgery: A Randomized Controlled Trial

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