Synthetic Osmotic Dilators for Pre-Induction Cervical Ripening – an Evidence-Based Review

Abstract Mechanical methods have gained growing interest for pre-induction cervical ripening in women with an unripe cervix, since they a better safety profile compared to prostaglandins. Balloon catheters been the gold standard method decades, while there was lack of data on synthetic osmotic dilators. Not until 2015, when Dilapan-S approved by Food and Drug Administration (FDA) induction labor, numerous studies published use this field. The rate vaginal deliveries associated ranges from 61.6 81.7%, no serious complications needing further interventions reported date. shown be as effective Foley balloon catheter well 10 mg PGE2 insert orally applied misoprostol (25 µg every 2 hours) achieving delivery, but patient’s satisfaction during process significantly higher other uterine hyperstimulation lower prostaglandins (PGs). Minor (e.g. bleeding) were < 2%, maternal infectious morbidity not or misoprostol. Due these beneficial properties might ideal option outpatient ripening, recent randomized clinical trial comparing inpatient ripening. Furthermore, according manufacturers’ product information, is only that contraindicated labor previous cesarean section. Upcoming guidelines should consider dilators safe ripening/induction acknowledging more evidence-based are mandatory, particularly patients