Adequate cervical preparation is important prior to surgical abortions because it helps to prevent complications of dilation and evacuation (D&E), such as laceration of the cervix.
[5] Cervical preparation can be accomplished with osmotic dilators, with medications such as prostaglandins and/or mifepristone, or with a combination of these.
However, there is no consensus as to which cervical preparation method is superior in terms of safety and efficacy.
Prior to a planned surgical abortion, osmotic dilator(s) may be inserted into a woman's cervix.
This may be affected by the gestational age of the pregnancy and history of prior vaginal deliveries.
[12] Laminaria are removed prior to initiating the D&E, after they have started the process of dilating the cervix.
[8] Dilapan may expand unevenly within the cervix and develop a dumbbell shape which can result in difficult removal.