Hygroscopic dilator (Dilapan-S) and misoprostol combination for the early first-trimester termination of pregnancy: a pilot study.

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.