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The use of an osmotic dilator for induction of miscarriage in patients with the second trimester missed miscarriage.

Abstract

Aim:

The aim of this study was to assess the outcomes of combined use of dilapan-S and pharmacological induction of miscarriage with mifepristone and misoprostol versus mifepristone and misoprostol only in patients with a second-trimester pregnancy loss. Materials and methods: Our study included 74 patients with a second-trimester antenatal death who were randomized into two groups to receive pharmacological induction of miscarriage combined with intracervical insertion of dilapan-S (n = 37) or pharmacological induction of miscarriage only (n = 37). Efficacy endpoints included: blood loss volume, length of time between the procedure initiation and complete miscarriage, and the number of complications.

Results:

The use of dilapan-S together with mifepristone and misoprostol for induction of miscarriage in the second trimester in women with antenatal fetal death reduced the time from the start of the procedure to complete miscarriage by 1.98-fold. However, the use of dilapan-S did not significantly reduce the odds of such post-procedural complications as hematometra and retention of the products of conception in the uterus (p = .2501).

Conclusions:

Combined management of antenatal pregnancy loss in the second trimester including intracervical insertion of dilapan-S and conventional induction with miscarriage may be considered a valuable clinical strategy. However, future studies should focus on ways to prevent postprocedural complications in this group of women.

Authors+Show Affiliations

2nd Department of Obstetrics and Gynecology, Omsk State Medical University , Omsk , Russia.2nd Department of Obstetrics and Gynecology, Omsk State Medical University , Omsk , Russia.2nd Department of Obstetrics and Gynecology, Omsk State Medical University , Omsk , Russia.2nd Department of Obstetrics and Gynecology, Omsk State Medical University , Omsk , Russia.2nd Department of Obstetrics and Gynecology, Omsk State Medical University , Omsk , Russia.Regional Tertiary Perinatal Center, Omsk Regional Clinical Hospital , Omsk , Russia.2nd Department of Obstetrics and Gynecology, Omsk State Medical University , Omsk , Russia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31570024

Citation

Barinov, Sergey V., et al. "The Use of an Osmotic Dilator for Induction of Miscarriage in Patients With the Second Trimester Missed Miscarriage." The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2019, pp. 1-5.
Barinov SV, Tirskaya YI, Shamina IV, et al. The use of an osmotic dilator for induction of miscarriage in patients with the second trimester missed miscarriage. J Matern Fetal Neonatal Med. 2019.
Barinov, S. V., Tirskaya, Y. I., Shamina, I. V., Medyannikova, I. V., Kadcyna, T. V., Shkabarnya, L. L., & Lazareva, O. V. (2019). The use of an osmotic dilator for induction of miscarriage in patients with the second trimester missed miscarriage. The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, pp. 1-5. doi:10.1080/14767058.2019.1671331.
Barinov SV, et al. The Use of an Osmotic Dilator for Induction of Miscarriage in Patients With the Second Trimester Missed Miscarriage. J Matern Fetal Neonatal Med. 2019 Oct 1;1-5. PubMed PMID: 31570024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of an osmotic dilator for induction of miscarriage in patients with the second trimester missed miscarriage. AU - Barinov,Sergey V, AU - Tirskaya,Yuliya I, AU - Shamina,Inna V, AU - Medyannikova,Irina V, AU - Kadcyna,Tatiana V, AU - Shkabarnya,Lyudmila L, AU - Lazareva,Oksana V, Y1 - 2019/10/01/ PY - 2019/10/2/entrez PY - 2019/10/2/pubmed PY - 2019/10/2/medline KW - Antenatal death KW - miscarriage induction KW - osmotic dilator SP - 1 EP - 5 JF - The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians JO - J. Matern. Fetal. Neonatal. Med. N2 - Aim: The aim of this study was to assess the outcomes of combined use of dilapan-S and pharmacological induction of miscarriage with mifepristone and misoprostol versus mifepristone and misoprostol only in patients with a second-trimester pregnancy loss. Materials and methods: Our study included 74 patients with a second-trimester antenatal death who were randomized into two groups to receive pharmacological induction of miscarriage combined with intracervical insertion of dilapan-S (n = 37) or pharmacological induction of miscarriage only (n = 37). Efficacy endpoints included: blood loss volume, length of time between the procedure initiation and complete miscarriage, and the number of complications. Results: The use of dilapan-S together with mifepristone and misoprostol for induction of miscarriage in the second trimester in women with antenatal fetal death reduced the time from the start of the procedure to complete miscarriage by 1.98-fold. However, the use of dilapan-S did not significantly reduce the odds of such post-procedural complications as hematometra and retention of the products of conception in the uterus (p = .2501). Conclusions: Combined management of antenatal pregnancy loss in the second trimester including intracervical insertion of dilapan-S and conventional induction with miscarriage may be considered a valuable clinical strategy. However, future studies should focus on ways to prevent postprocedural complications in this group of women. SN - 1476-4954 UR - https://www.unboundmedicine.com/medline/citation/31570024/The_use_of_an_osmotic_dilator_for_induction_of_miscarriage_in_patients_with_the_second_trimester_missed_miscarriage L2 - http://www.tandfonline.com/doi/full/10.1080/14767058.2019.1671331 DB - PRIME DP - Unbound Medicine ER -