Single versus multiple cervical dilation by osmotic dilator before induction of labor for second-trimester abortion.

Lee M, Mimura K, Endoh M, Kawanishi Y, Miyake T, Kakigano A, Takiuchi T, Matsuzaki S, Tomimatsu T, Kimura T.

Obstetrics & Gynecology
Feb 2019


In this study, we aimed to investigate whether there was a significant prognostic difference between single and multiple cervical dilations when inducing second‐trimester abortion.


We conducted a retrospective review of 238 pregnant women who underwent termination of pregnancy at 12–21 weeks of gestation at Osaka University Hospital in Osaka, Japan, between January 2010 and May 2018. Termination of pregnancy was performed by vaginal administration of 1 mg gemeprost every 3 h for up to five doses per day after uterine cervical dilation using lamicel.


The women were categorized into two groups: 191 women had a delivery time of <24 h, whereas 47 had delivery times >24 h. Contrasting the groups, there were significant differences with regard to numbers of primiparas (88 [46.1%] and 32 [68.1%], respectively) and lamicel exchanges ± SD (1.9 ± 0.67 for <24 h and 2.4 ± 0.87 for >24 h, respectively). Additionally, we compared the prognosis of primiparas that received just a single lamicel with that of primiparas that had ≥2 exchanged, but no significant differences were noted in the number of patients with a delivery time of >24 h and the number of used gemeprost.


Primipara is a risk factor for delayed delivery time of induced abortion. However, increasing the number of exchanged lamicel did not significantly reduce the delivery time; therefore, it should be performed as minimally as possible.