Cervical preparation before second trimester dilation and evacuation (D&E) reduces risks and
complications. Osmotic cervical dilators as well as prostaglandin analogues have been studied
for cervical preparation. However, the optimal method for cervical preparation, especially
for D&E procedures that occur on the same day as cervical preparation, is not known. This
study will investigate misoprostol versus placebo as an adjunct to Dilapan-S for cervical
preparation for same-day D&E between 16+0 and 20+6 weeks gestation.
HYPOTHESIS: Administration of 400 µg buccal misoprostol compared to placebo at least 3 hours
prior to D&E as an adjunct to cervical preparation with Dilapan-S will decrease operative
time for same-day D&E performed between 16+0 and 20+6 weeks.