Late pregnancy termination by a medical technique in combination with cervical osmotic dilators

Tyutyunnik V.L., Dikke G.B., Kan N.E., Uzdenova Z.Kh., Shcherbatykh E.Yu.

1) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) F.I. Inozemtsev Academy of Medical Education, Saint Petersburg, Russia; 3) Kh.M. Berbekov Kabardino-Balkar State University, Nalchik, Russia; 4) OOO “Umnaya Meditsina” (Smart Medicine), Moscow Region, Russia
Objective. To analyze the effectiveness of late pregnancy termination by mifepristone/misoprostol in combination with Dilapan-S cervical osmotic dilators.
Materials and methods. The publications available in the Cochrane and PubMed databases, as well as the guidelines of international and Russian professional communities and the clinical trials published in the public domain were analyzed.
Results. The review presents scientific data suggesting that Dilapan-S osmotic dilators in the simultaneous use of mifepristone and misoprostol can achieve cervical dilation, induction of uterine contractility, and pregnancy termination in a shorter time (within one day) than mifepristone/misoprostol only. The use of Dilapan-S is shown to be more preferable than that of Laminaria in the medical pregnancy termination protocols.
Conclusion. The most optimal procedures for cervical preparation have not yet been determined and further investigations are needed to work out clearer recommendations for specific clinical situations.


surgical abortion
medical abortion
cervical preparation


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Received 09.04.2019

Accepted 19.04.2019

About the Authors

Tyutyunnik, Victor L., MD, the head of the obstetric physiological department of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Health of Russia. 117997, Moscow, Ac. Oparina str., 4. Tel.: +79039695041. E-mail: Number Researcher ID B-2364-2015.ORCID ID 0000-0002-5830-5099.
Dikke, Galina B., MD, professor of the Department of Obstetrics and Gynecology with a course of reproductive medicine, Academy of Medical Education named
F.I. Inozemtsev. 190013, Russia, St. Petersburg, Moscow Ave, 22, letter M. Tel.: +78123347650. E-mail: 0000-0001-9524-8962.
Kan, Natalia E., MD, professor of the Department of Obstetrics and Gynecology, National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str., 4. Tel.: +79262208655. E-mail:
Number Researcher ID B-2370-2015. ORCID ID 0000-0001-5087-5946
Uzdenova, Zuhra Kh., MD, professor of the Department of Pediatric Diseases, Obstetrics and Gynecology, honored doctor of the Kabardino-Balkarian Republic,
Kabardino-Balkarian State University named H.M. Berbekov, Nalchik. Russia, KBR, Nalchik, Chernyshevskogo st., 173. Tel.: +79280847770. E-mail:
Shcherbatykh Evgenia Yu., PhD, medical center «Smart Medicine», obstetrician-gynecologist.
140140, Russia, Moscow region, Ramensky district, Udelnaya village, Goryachev str. 36/1. Tel.: +7-499-707-26-56. E-mail:

For citation: Tyutyunnik V.L., Dikke G.B., Kan N.E., Uzdenova Z.Kh., Shcherbatykh E.Yu. Late pregnancy termination by a medical technique in combination with cervical osmotic dilators. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; (5): 149-54. (in Russian)

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