Cervical dilation in second-trimester abortion

Clin Obstet Gynecol. 2009 Jun;52(2):171-8. doi: 10.1097/GRF.0b013e3181a2b3cd.


Dilation and evacuation, the most common method performed for second-trimester abortion in the United States, requires sufficient cervical dilation to reduce the risk of complications such as cervical laceration or uterine perforation. The cervix may be prepared with osmotic dilators such as laminaria, Lamicel, or Dilapan-S, or with pharmacologic agents such as misoprostol. Dilapan-S and Lamicel achieve their maximum dilation faster than laminaria, making same-day procedures possible. Misoprostol has limited data supporting its use in this setting. Decisions regarding which method is best are clinician-dependent, and factors such as gestational age and time allowed for preparation should be considered.

Publication types

  • Review

MeSH terms

  • Abortifacient Agents, Nonsteroidal / administration & dosage
  • Abortion, Induced / methods*
  • Biocompatible Materials / therapeutic use
  • Cervix Uteri
  • Device Removal
  • Dilatation / instrumentation
  • Dilatation / methods*
  • Female
  • Humans
  • Laminaria
  • Magnesium Sulfate / therapeutic use
  • Misoprostol / administration & dosage
  • Polymers / therapeutic use
  • Polyvinyl Alcohol / therapeutic use
  • Pregnancy
  • Pregnancy Trimester, Second


  • Abortifacient Agents, Nonsteroidal
  • Biocompatible Materials
  • Lamicel
  • Polymers
  • Misoprostol
  • dilapan
  • Magnesium Sulfate
  • Polyvinyl Alcohol