Mifepristone vs. osmotic dilator insertion for cervical preparation prior to surgical abortion at 14-16 weeks: a randomized trial.
BACKGROUND
Cervical preparation is recommended before second-trimester abortion. We investigated the use of a pharmacologic method of preparation, mifepristone, as compared to osmotic dilators for surgical abortions at 14-16 weeks.


METHODS
This was a randomized, parallel-group study with concealed allocation. Women were allocated to receive osmotic dilators or mifepristone 200 mg orally 24 h prior to abortion. The study population was 50 women seeking surgical abortion at 14-16 menstrual weeks in a hospital-based abortion service. The primary outcome was the length of time to perform the procedure; the study had 80% power to detect a difference of more than 3 min in procedure time. Secondary outcomes included cervical dilation, side effects and acceptability.


RESULTS
The mean abortion time for the osmotic dilator group was 8.00 min [95% confidence interval (CI) 6.75-11.47], and that for the mifepristone group was 9.87 min (95% CI 8.93-11.36). Side effects of pain were more common in the osmotic dilator group.


CONCLUSIONS
Mifepristone did not increase the time for abortion by more than the prespecified margin (3 min). Women preferred mifepristone to osmotic dilators.
Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA 021128, USA. lynn.borgatta@bmc.org
Lynn
L
Borgatta
Danielle
D
Roncari
Sarita
S
Sonalkar
Alice
A
Mark
Melody Y
MY
Hou
Molly
M
Finneseth
Olivera
O
Vragovic
D000019:Abortifacient Agents / Q000008:administration & dosage*; D000021:Abortifacient Agents, Steroidal; D000028:Abortion, Induced / Q000379:methods*; D000293:Adolescent; D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007747:Labor Stage, First / Q000187:drug effects; D007795:Laminaria; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage*; D009994:Osmolar Concentration; D057240:Patient Preference; D011108:Polymers; D011247:Pregnancy; D013997:Time Factors
D000019:Abortifacient Agents; D000021:Abortifacient Agents, Steroidal; D011108:Polymers; C077755:dilapan; D015735:Mifepristone