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Hygroscopic dilator (Dilapan-S™) and misoprostol combination for the early first-trimester termination of pregnancy: a pilot study
  1. Mannampallil I Samuel, MRCOG, MFSRH, Associate Specialist1 and
  2. John H Parsons, FRCOG, Consultant2
  1. Department of Sexual Health, King's College Hospital NHS Trust, London, UK
  2. Department of Obstetrics and Gynaecology, King's College Hospital NHS Trust, London, UK
  1. Correspondence to Dr Mannampallil Samuel, Department of Sexual Health, King's College Hospital, 100 Denmark Hill, London SE5 9RS, UK. E-mail: ittysamuel{at}


Background and methodology 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.

Discussion and 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.

  • dilapan-s™
  • early medical abortion
  • mifepristone
  • misoprostol
  • pain in abortion

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