Effect of the addition of osmotic dilators to medical induction of labor abortion: A before-and-after study.

ABSTRACT

OBJECTIVES: The main objective of this study was to assess the induction-to-delivery interval with or without the use of osmotic dilators for induced abortion. As secondary objectives, women outcomes were assessed. STUDY DESIGN: This retrospective single-center observational before and after study reviewed records from a university hospital maternity unit from 2002 through 2016 and included all women undergoing abortion for medical reasons at and after 14 weeks of gestation. Two groups were compared group "no dilators", which used first misoprostol without dilators, and group "dilators", which used osmotic dilators before misoprostol administration. The main outcome was the induction-to-delivery interval. RESULTS: The study included 491 women 383 in group "no dilators" and 108 in group "dilators". The induction-delivery interval was significantly lower in the group "dilators" compared to "no dilators" (427.7 min vs 639.7 min, P < 0.001), as was the cumulative misoprostol dose (990 µg vs 1449 µg, P < 0.001). The delivery rate within 6 h was significantly higher in the "dilators" group compared to "no dilators" group (50.0% vs 29.8%, P = 0.002). CONCLUSION: The use of osmotic dilators for cervical ripening before administration of misoprostol for induced abortion appears to be effective in reducing the induction-delivery interval.