Adjunctive Agents for Cervical Preparation in Second Trimester Surgical Abortion
Tóm tắt
Late second trimester dilation and evacuation is a challenging subset of surgical abortion. Among the reasons for this is the degree of cervical dilation required to safely extricate fetal parts. Cervical dilation is traditionally achieved by placing multiple sets of osmotic dilators over two or more days prior to the evacuation procedure; however, there is interest in shortening cervical preparation time. The use of adjuvant mifepristone and misoprostol in conjunction with osmotic dilators has been studied for this purpose, and their use demonstrates that adequate cervical dilation can be achieved in less time than with dilators alone. We present a review of the current evidence surrounding adjunctive agents for cervical preparation, and contend that for women presenting for surgical abortion care above 19 weeks gestation, the use of adjunctive mifepristone and/or misoprostol should be strongly considered along with osmotic dilator insertion when cervical preparation in less than 24 h is needed.
Tài liệu tham khảo
Kerns J, Vanjani R, Freedman L, Meckstroth K, Drey EA, Steinauer J. Women’s decision making regarding choice of second trimester termination method for pregnancy complications. Int J Gynaecol Obstet. 2012;116(3):244–8.
Thorp JM Jr. Public health impact of legal termination of pregnancy in the US: 40 years later. Scientifica (Cairo). 2012;2012:980812.
Peterson WF, Berry FN, Grace MR, Gulbranson CL. Second-trimester abortion by dilatation and evacuation: an analysis of 11,747 cases. Obstet Gynecol. 1983;62(2):185–90.
Ngai SW, Chan YM, Tang OS, Ho PC. The use of misoprostol for pre-operative cervical dilatation prior to vacuum aspiration: a randomized trial. Hum Reprod. 1999;14(8):2139–42.
Nucatola D, Roth N, Saulsberry V, Gatter M. Serious adverse events associated with the use of misoprostol alone for cervical preparation prior to early second trimester surgical abortion (12–16 weeks). Contraception. 2008;78(3):245–8.
MacIsaac L, Grossman D, Balistreri E, Darney P. A randomized controlled trial of laminaria, oral misoprostol, and vaginal misoprostol before abortion. Obstet Gynecol. 1999;93(5 Pt 1):766–70.
Allen RH, Goldberg AB. Cervical dilation before first-trimester surgical abortion (< 14 weeks’ gestation). Contraception. 2016;93:277–91.
Clark K, Ji H, Feltovich H, Janowski J, Carroll C, Chien EK. Mifepristone-induced cervical ripening: structural, biomechanical, and molecular events. Am J Obstet Gynecol. 2006;194(5):1391–8.
Gemzell-Danielsson K, Bygdeman M, Aronsson A. Studies on uterine contractility following mifepristone and various routes of misoprostol. Contraception. 2006;74(1):31–5.
Hayes JL, Fox MC. Cervical dilation in second-trimester abortion. Clin Obstet Gynecol. 2009;52(2):171–8.
Shulman LP, Ling FW, Meyers CM, Shanklin DR, Simpson JL, Elias S. Dilation and evacuation for second-trimester genetic pregnancy termination. Obstet Gynecol. 1990;75(6):1037–40.
Burnett MA, Corbett CA, Gertenstein RJ. A randomized trial of laminaria tents versus vaginal misoprostol for cervical ripening in first trimester surgical abortion. J Obstet Gynaecol Can. 2005;27(1):38–42.
Edelman AB, Buckmaster JG, Goetsch MF, Nichols MD, Jensen JT. Cervical preparation using laminaria with adjunctive buccal misoprostol before second-trimester dilation and evacuation procedures: a randomized clinical trial. Am J Obstet Gynecol. 2006;194(2):425–30.
Drey EA, Benson LS, Sokoloff A, Steinauer JE, Roy G, Jackson RA. Buccal misoprostol plus laminaria for cervical preparation before dilation and evacuation at 21–23 weeks of gestation: a randomized controlled trial. Contraception. 2014;89(4):307–13.
Patel A, Talmont E, Morfesis J, et al. Adequacy and safety of buccal misoprostol for cervical preparation prior to termination of second-trimester pregnancy. Contraception. 2006;73(4):420–30.
Lyus R, Lohr PA, Taylor J, Morroni C. Outcomes with same-day cervical preparation with Dilapan-S osmotic dilators and vaginal misoprostol before dilatation and evacuation at 18 to 21+ 6 weeks’ gestation. Contraception. 2013;87(1):71–5.
Boraas CM, Achilles SL, Cremer ML, Chappell CA, Lim SE, Chen BA. Synthetic osmotic dilators with adjunctive misoprostol for same-day dilation and evacuation: a randomized controlled trial. Contraception. 2016;94(5):467–72.
Singh K, Fong YF, Prasad RN, Dong F. Randomized trial to determine optimal dose of vaginal misoprostol for preabortion cervical priming. Obstet Gynecol. 1998;92(5):795–8.
Singh K, Fong YF, Prasad RN, Dong F. Evacuation interval after vaginal misoprostol for preabortion cervical priming: a randomized trial. Obstet Gynecol. 1999;94(3):431–4.
Meckstroth KR, Whitaker AK, Bertisch S, Goldberg AB, Darney PD. Misoprostol administered by epithelial routes: drug absorption and uterine response. Obstet Gynecol. 2006;108(3 Pt 1):582–90.
Borgatta L, Kapp N, Society of Family Planning. Clinical guidelines. Labor induction abortion in the second trimester. Contraception. 2011;84(1):4–18.
Goldberg A, Fortin JA, Drey EA, et al. Cervical preparation before dilation and evacuation using adjunctive misoprostol or mifepristone compared with overnight osmotic dilators alone: a randomized controlled trial. Obstet Gynecol. 2015;126:599–609.
Shaw KA, Shaw JG, Hugin M, Velasquez G, Hopkins FW, Blumenthal PD. Adjunct mifepristone for cervical preparation prior to dilation and evacuation: a randomized trial. Contraception. 2015;91(4):313–9.
Shaw KA, Lerma K, Shaw JG, et al. Preoperative effects of mifepristone for dilation and evacuation after 19 weeks of gestation: a randomised controlled trial. BJOG. 2017;124(13):1973–81.
American College of Obstetricians and Gynecologists, Society of Family Planning. Medical management of first-trimester abortion. Contraception. 2014;89(3):148–61.
Swahn ML, Bygdeman M. The effect of the antiprogestin RU 486 on uterine contractility and sensitivity to prostaglandin and oxytocin. Br J Obstet Gynaecol. 1988;95(2):126–34.
Creinin MD, Schreiber CA, Bednarek P, et al. Mifepristone and misoprostol administered simultaneously versus 24 hours apart for abortion: a randomized controlled trial. Obstet Gynecol. 2007;109(4):885–94.
Spitz IM, Bardin CW. Mifepristone (RU 486)—a modulator of progestin and glucocorticoid action. N Engl J Med. 1993;329(6):404–12.
Bygdeman M, Swahn ML, Gemzell-Danielsson K, Svalander P. Mode of action of RU 486. Ann Med. 1993;25(1):61–4.