Cochrane Database Syst Rev 2025. doi: 10.1002/14651858.CD007310.pub3
Cervical preparation prior to surgical abortion from 12 to 24 weeks’ gestation is recommended to reduce the risk of complications. This Cochrane review assessed 21 randomised controlled trials (RCTs) with a total of 3029 participants to ascertain the most effective cervical preparation. It found that misoprostol plus osmotic dilators probably reduces procedure time and increases pre-procedure cervical dilation in comparison with osmotic dilators with placebo. Osmotic dilators plus mifepristone may reduce procedure time and probably increase pre-procedure dilatation when compared with osmotic dilators with placebo. When compared with the same-day Dilapan-S osmotic dilator, overnight laminaria may reduce procedure time and increase pre-procedure dilatation. Although this review provides a comprehensive assessment of pre-procedure regimens, it did not consider technician or patient acceptability.
Cochrane…