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Third, due to the nature of the cervical effacement process, enzymes and other mediators that regulate allergic and inflammatory responses are also involved. [6] One of the immunomodulating factors, mast cells, is known to secrete inflammatory mediators that modulate the process of cervical ripening through mast cell degranulation. [8]
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.
Cervical dilation (or cervical dilatation) is the opening of the cervix, the entrance to the uterus, during childbirth, miscarriage, induced abortion, or gynecological surgery. Cervical dilation may occur naturally, or may be induced surgically or medically.
Prostaglandin E 2 (PGE 2) achieves cervical ripening and softening by stimulating uterine contractions as well as directly acting on the collagenase present in the cervix to soften it. [7] There are currently two formulations of PGE 2 analog available for use in cervical ripening: Prepidil, a vaginal gel, and Cervidil, a vaginal insert. [24]
Cook Medical Double Balloon known as the Cervical Ripening Balloon with Stylet for assisted placement is FDA approved. The Double balloon provides one balloon to be inflated with saline on one side of the Uterine side of the cervix and the second balloon to be inflated with saline on the vaginal side of the cervix.
Dilation and evacuation can be offered for the management of second trimester miscarriage if skilled providers are available. [6] Some women choose D&E over labor induction for a second trimester loss because it can be a scheduled surgical procedure, offering predictability over labor induction, or because they find it emotionally easier than undergoing labor and delivery.
Cervical ripening is the physical and chemical changes in the cervix to prepare it for the stretching that will take place as the fetus moves out of the uterus and into the birth canal. A scoring system called a Bishop score can be used to judge the degree of cervical ripening to predict the timing of labour and delivery of the infant or for ...
Hegar dilators are used to induce cervical dilation in order to gain entry to the interior of the uterus. During the process of dilation, the cervix may have to be stabilized with a tenaculum , and then the dilators are slowly entered into the cervical canal with a lubricant, starting with a thin, low Hegar number rod and progressing gradually ...