The trend of non-pharmacological labour induction is rising.

According to 2021 European market survey, over 50% of clinicians predict an increase in the popularity of mechanical methods for labour induction in the coming years.

DILAPAN-S represents a non-pharmacological method recommended by the NICE guideline. It is a synthetic osmotic cervical dilator produced from a patented Aquacryl® hydrogel specifically developed for obstetrics and gynaecology.

Key benefits

Reducing load on maternity units

Reduction in staff time requirement by 2.4 hours vs dinoprostone

Non-pharma mode of action offers predictability and ease of scheduling

Minimal complications and no requirement for CTG monitoring or special care

Efficacy

First-round cervical ripening success rate higher than dinoprostone

Vaginal delivery rate comparable to prostaglandins

Vaginal delivery rate within 24 hours comparable to low-dose oral misoprostol

Safety

Minimizes the risk of hyperstimulation with NRFHR* changes

No serious adverse neonatal outcomes

Significantly reduced analgesia need

^{*NRFHR = Non-Reassuring Fetal Heart Rate}

Maternal satisfaction

Superior to prostaglandins and Foley catheter

Improved ability to relax, move and sleep vs other cervical ripening methods

Versatility

Broad utility for most patient types

A recommended option for out-patient ripening

Midwife insertion possible

A set of 4–5 DILAPAN-S is usually used to ripen the cervix sufficiently.

DILAPAN-S is fully comparable to pharmacological methods in vaginal delivery rate while offering safety benefits and superior maternal satisfaction.

How does DILAPAN-S expand?

The dilator increases in volume by absorbing fluid from the cervical tissue.

Achieved cervical dilation depends on the length of DILAPAN-S insertion.

The thin 4 mm dilator can expand up to 15 mm over a 12-24 hour period (free swelling).

Recommended by NICE IOL Guideline [NG207]

DILAPAN-S is listed among recommended methods for routine use by the NICE guideline.

The guideline recommends discussing with women the risks and benefits of each method, incl. the safety benefits of mechanical methods and the safety risks of pharmacological approaches.

Biophysical

Osmotic dehydratation of cervix → softening and change in consistency of tissue

Mechanical

Expanding dilators exert radial pressure against the wall of cervical canal → gradual dilatation of the cervix

Physiological

Continuous pressure stimulates the release of endogenous prostaglandins → effacement of the cervix

The above 3 mechanisms make DILAPAN-S a unique method of cervical ripening.

After removal of Dilapan-S, the ripe cervix may appear less effaced than with other protocols, but will be notably soft, stretchy and dilated.

After ARM, it can be expected that the pressure of the fetal head on the stretchy, softened tissue will support further effacement and dilation.

Example of optimised ripening algorithm with DILAPAN-S

Clinical study says

“DILAPAN-S is fully comparable to pharmacological methods in vaginal delivery rate, while offering better safety profile and superior maternal satisfaction.”

“DILAPAN-S improves maternal satisfaction during cervical ripening, incl. pain decrease reported by mothers.”

“DILAPAN-S can help to manage an issue of uterine tachysystole related to pharmacological cervical ripening.”

“Induction with DILAPAN-S helps to decrease a need of analgesics, incl. strong opioids.”

“First round cervical ripening success rate with DILAPAN-S is around 80%. In SOLVE trial the rate was approximately by 10% higher than with Propess.”

More studies