Osmotic cervical dilators

Name	Material	Size (dry diameter x length) (mm)	Dilation	Comments
Natural
Laminaria (Laminaria japonica, Laminaria digitata)	Dried compressed seaweed stalk	2 to 10 x 60 to 85	4 hours: 25 percent increase in diameter Overnight: 90 percent increase in diameter^[1]	Multiple laminaria are generally used.
Synthetic
Dilapan-S	Polyacrylate-based hydrogel rod	3 x 55 4 x 55 4 x 65	4 hours:	A previous version, Dilapan, had a tendency to break under high mechanical force; there have been no reports of breakage with Dilapan-S.^[3]
			3 mm size: Dilates to 8 mm 4 mm size: Dilates to 8.5 mm
			16 to 20 hours:
			3 mm size: Dilates to 10 mm 4 mm size: Dilates to 11.3 mm^[2]

The manufacture of lamicel, a polyvinyl alcohol polymer sponge soaked in 500 mg magnesium sulfate, was discontinued in 2008.

Data from:
1. Krammer J, O'Brien WF. Mechanical methods of cervical ripening. Clin Obstet Gynecol 1995; 38:280.
2. Bokstrom H, Wiqvist N. Preoperative dilatation of the cervix at legal abortion with a synthetic, fast-swelling hygroscopic tent. Acta Obstet Gynecol Scand 1989; 68:313.
3. Allen RH, Goldberg AB. Cervical dilation before first-trimester surgical abortion (<14 weeks' gestation). SFP Guideline 20071. Contraception 2007; 76:139.
4. Nicolaides KH, Welch CC, Koullapis EN, Filshie GM. Cervical dilatation by Lamicel-studies on the mechanism of action. Br J Obstet and Gynaecol 1983; 90:1060.
5. Nicolaides KH, Welch MacPherson MB, Johnson IR, et al. Br J Obstet Gynaecol 1983; 90:475.

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Osmotic cervical dilators