DILAPAN-S is a synthetic osmotic cervical dilator used for cervical softening and dilation in various medical procedures such as cervical ripening before labour induction, hysteroscopy, and IUD insertion. It’s recommended in multiple national clinical guidelines, including NICE. For a complete list of approved indications, refer to the product’s Instructions for Use.

DILAPAN-S consists of a hydrogel Aquacryl® active part, developed specifically for obstetrics and gynaecology, a polypropylene handle, and a marker string. It’s a mechanical cervical preparation method without any pharmacologically active substances.

DILAPAN-S absorbs fluids from the cervical tissue, expanding from 4mm to up to 15mm over 12–24 hours. This causes cervical softening and dilation, with most expansion occurring within the first 4–6 hours. Continuous pressure on cervical tissue stimulates the release of endogenous prostaglandins, promoting cervical effacement. Due to its mechanical mode of action, DILAPAN-S is highly predictable and allows easy scheduling of patients.

The number of dilators varies based on the indication, cervical condition, and desired outcome. For instance, 4–5 dilators are often used for labour induction with successful cervical ripening in approximately 80% of induced women, while one 3mm dilator may suffice for IUD insertion or embryo transfer. The maximum number is not defined in the product’s Instructions for Use; always take into account the clinical judgement of the risk/benefit ratio and mode of action.

The duration varies from a few hours to a maximum of 24 hours, depending on the indication. For labour induction, it’s typically 12–15 hours. Many hospitals choose to leave it in overnight as its gentle mode of action means patients are usually comfortable enough to rest and sleep.

DILAPAN-S is inserted by healthcare professionals using a bivalve speculum or digitally. The procedure entails sequentially inserting DILAPAN-S dilators, one after the other, usually with metal sponge forceps, making sure each dilator passes through the internal os. Please watch the training video which describes the insertion technique in more detail.

Insertion can be uncomfortable, similar to a vaginal examination, but pain levels vary among individuals. A clinical trial comparing DILAPAN-S with dinoprostone vaginal insert reported that the pain experienced during product placement was similar between both groups.

Post-DILAPAN-S, the cervix is usually soft, stretchy, and dilated, prepared for further induction procedures like artificial rupture of membranes or oxytocin augmentation. It may appear less effaced compared to other methods; however, it is usually prepared sufficiently. The pressure of the fetal head on the stretchy, softened tissue will support further effacement and dilation.

While theoretically possible, clinical evidence doesn’t link DILAPAN-S insertion to rupture of membranes (ROM). Rupture of membranes can occur spontaneously during the cervical ripening process and usually suggests the onset of labour. In this case, the dilators should be removed, and a vaginal examination performed.

Additional CTG monitoring is not mandatory during DILAPAN-S use, as clinical evidence indicates it minimises the risk of uterine tachysystole and non-reassuring fetal heart rate changes. After DILAPAN-S insertion, patients can mobilise or be sent home for outpatient ripening, if applicable.

Dilators should be removed by a professional within 12–15 hours by grasping the handle or pulling the string. Spontaneous falling out may indicate labour onset. Please watch the training video which describes how to remove DILAPAN-S, and read the Instructions for Use before using the product.

DILAPAN-S achieves reliable first-round cervical ripening success. In clinical trials on over 1000 women, approximately 4 out of 5 ripen successfully after the first round of DILAPAN-S. In the SOLVE trial, the first-round success rate was approximately 10% higher than with dinoprostone.

DILAPAN-S is not contraindicated in PROM cases. There is anecdotal clinical evidence, proposing its use is effective and safe.

DILAPAN-S is not contraindicated in cases of previous Caesarean section. Several clinical trials evaluated using DILAPAN-S for VBAC/TOLAC, concluding that DILAPAN-S can be an effective and safe option for these patients.

The only listed contraindication is the presence of a clinically apparent genital tract infection.

DILAPAN-S is suitable for most patient groups, except those with clinically apparent genital tract infection.

No. Patients can mobilise immediately after insertion, which can enhance cervical ripening.

Yes, DILAPAN-S is effective and safe for outpatient use, as confirmed by recent clinical trials and recommended by NICE. Outpatient cervical ripening significantly shortens the length of stay in hospital, increases vaginal delivery rate within 24 hours after admission, and further improves maternal satisfaction.

There are no specific gestational age limitations; use depends on the clinical judgement.