Osmotic Dilator Intra-Abdominal Perforation: A Case Report

Harjee, Rahana; Bahrani, Reem; Chan, Michelle; Mehra, Neeraj; Pang, Emily; Fitzsimmons, Brian

doi:10.1016/j.jogc.2019.07.006

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…On the other hand, osmotic dilators are well-known cervical ripening agents with high efficiency and a small percentage of adverse effects. Their major drawbacks are the prolonged time required for cervical preparation and the need for vaginal examination with a speculum for proper application of the rod [ 84 ]. The main risks associated with using osmotic agents are pain, vasovagal reactions, allergic reactions, infection (rather when using Laminaria than synthetic dilators), and the possibility of dilator entrapment leading to intra-abdominal perforation [ 44 , 55 , 84 , 85 – 88 ].…”

Section: Surgical Abortionmentioning

confidence: 99%

“…Their major drawbacks are the prolonged time required for cervical preparation and the need for vaginal examination with a speculum for proper application of the rod [ 84 ]. The main risks associated with using osmotic agents are pain, vasovagal reactions, allergic reactions, infection (rather when using Laminaria than synthetic dilators), and the possibility of dilator entrapment leading to intra-abdominal perforation [ 44 , 55 , 84 , 85 – 88 ]. Research shows that both Laminaria and misoprostol provide sufficient dilatation of the cervical canal for surgical abortion [ 87 , 88 ].…”

Section: Surgical Abortionmentioning

confidence: 99%

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A Review of the Mechanism of Action and Clinical Applications of Osmotic Dilators for Cervical Ripening in the Induction of Labor and in Gynecology Procedures

Socha¹,

Flis²,

Wartęga

et al. 2023

Med Sci Monit

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Cervical ripening is defined as the significant softening of the cervical tissue that usually begins before the onset of contractions during labor, and is required for cervical dilation and delivery. Osmotic dilators are medical implements that dilate the uterine cervix by increasing in size as they absorb fluid from the surrounding tissue. This article aims to review the mechanisms and applications of osmotic dilators for cervical ripening in the induction of labor and in gynecology procedures.

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Section: Surgical Abortionmentioning

confidence: 99%

Section: Surgical Abortionmentioning

confidence: 99%

A Review of the Mechanism of Action and Clinical Applications of Osmotic Dilators for Cervical Ripening in the Induction of Labor and in Gynecology Procedures

Socha¹,

Flis²,

Wartęga

et al. 2023

Med Sci Monit

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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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Osmotic Dilator Intra-Abdominal Perforation: A Case Report

Cited by 2 publications

References 3 publications

A Review of the Mechanism of Action and Clinical Applications of Osmotic Dilators for Cervical Ripening in the Induction of Labor and in Gynecology Procedures

A Review of the Mechanism of Action and Clinical Applications of Osmotic Dilators for Cervical Ripening in the Induction of Labor and in Gynecology Procedures

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

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