title: Hygroscopic dilator (Dilapan-S) and misoprostol combination for the early first-trimester termination of pregnancy: a pilot study.
abstract: METHODS
  Uptake of the mifepristone/misoprostol combination to induce early medical abortion in England and Wales has been slow. Women's concern that early medical abortion is painful may be a contributory factor. This pilot study evaluated the pain experienced by women when Dilapan-S, a synthetic hygroscopic dilator (polyacrylonitrile) is used instead of mifepristone as cervical preparation prior to administration of a misoprostol.
  
  
  RESULTS
  Of 25 patients completing the trial, 17 aborted in a median of 6 hours with an interquartile range of 4.5-11.5 hours. Of these, 15 patients recorded mild discomfort only, 14 considered the procedure excellent and three good.
  
  
  CONCLUSIONS
  This study suggests that the Dilapan-S/misoprostol combination reduces the pain associated with early medical abortion. Further investigation of the protocol is merited.
authors.affiliation: Department of Sexual Health, King's College Hospital NHS Trust, 100 Denmark Hill, London SE5 9RS, UK. ittysamuel@hotmail.co.uk
authors.forename: Mannampallil I
authors.initials: MI
authors.lastname: Samuel
authors.forename: John H
authors.initials: JH
authors.lastname: Parsons
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000009:adverse effects / Q000379:methods*; D004106:Dilatation / Q000295:instrumentation*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015735:Mifepristone / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010865:Pilot Projects; D011108:Polymers / Q000008:administration & dosage; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D017155:Wettability
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D011108:Polymers; D016595:Misoprostol; C077755:dilapan; D015735:Mifepristone