Mifepristone and misoprostol compared to osmotic dilators for cervical preparation prior to surgical abortion at 15–18 weeks' gestation: a randomised controlled non-inferiority trial

What is it about?

Cervical preparation, which means softening the cervix to allow it to dilate more easily, is recommended before second trimester surgical abortion. Historically in the United States, providers have used dilators to prepare the cervix, but the procedure to place dilators can be uncomfortable or painful for women. Our study looked at whether using a combination of two medicines, mifepristone and misoprostol, might work just as well (or no worse) than dilators to prepare the cervix. To answer this question, we randomly assigned 49 women having abortions at 15-18 weeks of pregnancy to have either dilators or medications for cervical preparation. We measured the time it took to complete the procedure, as well as whether the women had side effects, and finally how satisfied they were with the process. We found that the procedure took roughly the same time to complete no matter which group the women were in, and side effects occurred at around the same rate, but women in the medication group were more likely to say they would choose their modality again in the future. Our conclusion was that medications worked about as well as dilators to prepare a woman’s cervix for an abortion at 15-18 weeks and seemed to be more acceptable to patients.

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