Comparative assessment of current cervical preparation methods for surgical abortion and labor induction

Objective. To comparatively analyze current methods of cervical preparation for pregnancy termination and labor induction and to determine their benefits. Material and methods. Publications in the Cochrane databases, guidelines of international and national professional societies, and clinical trials, which have been released into the public domain, were examined. Results. The review presents the scientific evidence that suggests that osmotic dilators can achieve greater cervical dilation than mifepristone or misoprostol; dilapan is more preferable than laminaria sticks in same-day cervical dilation protocols. Labor induction using mechanical methods compared to prostaglandins results in similar results of cesarean section and in delivery duration of more than 24 hours, but with a lower risk for uterine hyperstimulation and fetal distress. Compared to oxytocin, mechanical methods have a lower risk of cesarean section. Conclusion. Despite some successes in the development of cervical preparation methods, the most appropriate ones of them have not yet been determined and further investigations are needed to work out more clear recommendations for specific clinical situations. © Team of authors, 2017.