{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T07:54:12Z","timestamp":1759564452191,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Fam Plann Reprod Health Care"],"accepted":{"date-parts":[[2008,7,12]]},"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background and methodology<\/jats:title>\n                  <jats:p>Uptake of the mifepristone\/misoprostol combination to induce early medical abortion in England and Wales has been slow. Women's concern that early medical abortion is painful may be a contributory factor. This pilot study evaluated the pain experienced by women when Dilapan-S<jats:sup>\u2122<\/jats:sup>, a synthetic hygroscopic dilator (polyacrylonitrile) is used instead of mifepristone as cervical preparation prior to administration of a misoprostol.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 25 patients completing the trial, 17 aborted in a median of 6 hours with an interquartile range of 4.5\u201311.5 hours. Of these, 15 patients recorded mild discomfort only, 14 considered the procedure excellent and three good.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and conclusions<\/jats:title>\n                  <jats:p>This study suggests that the Dilapan-S\/misoprostol combination reduces the pain associated with early medical abortion. Further investigation of the protocol is merited.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1783\/147118909787072234","type":"journal-article","created":{"date-parts":[[2009,1,5]],"date-time":"2009-01-05T17:44:33Z","timestamp":1231177473000},"page":"45-47","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Hygroscopic dilator (Dilapan-S\u2122) and misoprostol combination for the early first-trimester termination of pregnancy: a pilot study"],"prefix":"10.1136","volume":"35","author":[{"given":"Mannampallil I","family":"Samuel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John H","family":"Parsons","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2009,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.contraception.2006.03.002","article-title":"Treatment of pain in medical abortion","volume":"74","author":"Penney, G.","year":"2006","unstructured":"Penney G. Treatment of pain in medical abortion.Contraception 2006; 74: 45\u201347.","journal-title":"Contraception"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.contraception.2006.10.008","article-title":"Predictors of acceptability of medical abortion","volume":"75","author":"Teal, S.B.; Dempsey-Flanning, A.; Westoff, C.","year":"2007","unstructured":"Teal SB, Dempsey-Flanning A, Westoff C. Predictors of acceptability of medical abortion. Contraception 2007; 75: 224\u2013229.","journal-title":"Contraception"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1056\/NEJM199804303381801","article-title":"Early pregnancy termination with mifepristone and misoprostol in the United States","volume":"338","author":"Spitz, I.M.; Bardin, C.W.; Benton, L.; Robbins, A.","year":"1998","unstructured":"Spitz IM, Bardin CW, Benton L, Robbins A. Early pregnancy termination with mifepristone and misoprostol in the United States. N Engl J Med 1998; 338: 1241\u20131247.","journal-title":"N Engl J Med"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S0010-7824(00)00090-1","article-title":"Predictors of analgesia use during supervised medical abortion","volume":"61","author":"Westoff, C.; Dasmahapatra, R.; Winikoff, B.; Clarke, S.; the Mifepristone Trial Group","year":"2000","unstructured":"Westoff C, Dasmahapatra R, Winikoff B, Clarke S, and the Mifepristone Trial Group. Predictors of analgesia use during supervised medical abortion. Contraception 2000; 61: 225\u2013229.","journal-title":"Contraception"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1046\/j.1471-0528.2002.02156.x","article-title":"Factors affecting the outcome of early medical abortion: a review of 4132 consecutive cases","volume":"109","author":"Ashok, P.W.; Templeton, A.; Wagaarachchi, P.T.; Flett, G.M.M.","year":"2002","unstructured":"Ashok PW, Templeton A, Wagaarachchi PT, Flett GMM. Factors affecting the outcome of early medical abortion: a review of 4132 consecutive cases. Br J Obstet Gynaecol 2002; 109: 1281\u20131289.","journal-title":"Br J Obstet Gynaecol"},{"article-title":"Gynuity Health Projects (http:\/\/gynuity.org\/). Annotated bibliography on misoprostol alone for early abortion.http:\/\/www.rhtp.org\/news\/publications\/documents\/Miso%20for %20Pregnancy%20Termination","author":"Bibliography.pdf [7 May 2008].","key":"ref_6","unstructured":"Gynuity Health Projects (http:\/\/gynuity.org\/). Annotated bibliography on misoprostol alone for early abortion.http:\/\/www.rhtp.org\/news\/publications\/documents\/Miso%20for %20Pregnancy%20Termination.Bibliography.pdf [Accessed 7 May 2008]."},{"key":"ref_7","first-page":"978","article-title":"Oxford Handbook of Reproductive Medicine and Family Planning (Oxford Handbooks Series). Enda McVeigh, Roy Homburg, John Guillebaud","author":"-","year":"2008","unstructured":"Oxford Handbook of Reproductive Medicine and Family Planning (Oxford Handbooks Series). Enda McVeigh, Roy Homburg, John Guillebaud. Oxford, UK: Oxford University Press, 2008. ISBN-13: 978-0-19-920380-2. Price: \u00a324.95. Pages: 456 (paperback)"},{"key":"ref_8","first-page":"978","article-title":"Caring for Muslim Patientsn). Aziz Sheikh and Abdul Rashid Gatrad (eds)","author":"-","year":"2008","unstructured":"Caring for Muslim Patients (2nd edn). Aziz Sheikh and Abdul Rashid Gatrad (eds). Oxford, UK: Radcliffe Publishing Ltd, 2008. ISBN-13: 978-1-85-775812-2. Price: \u00a324.95. Pages: 158 (paperback)","edition":"2"},{"key":"ref_9","unstructured":"The chapter on the Muslim patient is particularly useful as it addresses a lot of day-today yet somewhat controversial issues around which many Muslims may have preconceived religious or cultural beliefs (e.g. gender segregation, intermarriage and elderly care). The topics of marriage and the family unit and its central role in Islamic society are elaborated well. Religious ceremonies and issues around prayer and Hajj are also discussed in an informative way. This will certainly provide all those who read this book with much-needed information on understanding this substantive group of patients.","article-title":"The chapter on the Muslim patient is particularly useful as it addresses a lot of day-today yet somewhat controversial issues around which many Muslims may have preconceived religious or cultural beliefs (e.g. gender segregation, intermarriage and elderly care). The topics of marriage and the family unit and its central role in Islamic society are elaborated well. Religious ceremonies and issues around prayer and Hajj are also discussed in an informative way. This will certainly provide all those who read this book with much-needed information on understanding this substantive group of patients"},{"key":"ref_10","unstructured":"The book should help bridge the gap and thus improve trust and understanding between patients and health care professionals. It also provides useful evidence from the 2001 census, which clearly showed the health inequalities suffered by the Muslim population. This is linked to poor housing and education in these areas.","article-title":"The book should help bridge the gap and thus improve trust and understanding between patients and health care professionals. It also provides useful evidence from the 2001 census, which clearly showed the health inequalities suffered by the Muslim population. This is linked to poor housing and education in these areas"},{"key":"ref_11","first-page":"978","article-title":"Caring for Hindu Patientsn). Diviash Thakrar, Rasamandala Das, Aziz Sheikh (eds)","author":"-","year":"2008","unstructured":"Caring for Hindu Patients (2nd edn). Diviash Thakrar, Rasamandala Das, Aziz Sheikh (eds). Oxford, UK: Radcliffe Publishing Ltd, 2008. ISBN-13: 978-1-85-775598-5. Price: \u00a324.95. Pages: 142 (paperback)","edition":"2"},{"key":"ref_12","unstructured":"Hindus form a significant proportion of the ethnic minority society in Britain today. Health care professionals in all settings and locations need an awareness of their beliefs and cultural expectations, to communicate effectively and provide care in an appropriate manner. This book provides that information in a concise and practical form. It gives a brief overview of the way of life that is now called \u2018Hinduism\u2019. The first section of the book describes issues relating to language, dress, diet and festivals, as well as traditions and customs that form an integral part of Hindus living anywhere in the world. The second section deals with issues relating to health care. Chapter 5 (marriage and family life) is the most important chapter for clinicians working in sexual and reproductive health since it focuses on marriage, family structure, sex, contraception, abortion, infertility and adoption.","article-title":"Hindus form a significant proportion of the ethnic minority society in Britain today. Health care professionals in all settings and locations need an awareness of their beliefs and cultural expectations, to communicate effectively and provide care in an appropriate manner. This book provides that information in a concise and practical form. It gives a brief overview of the way of life that is now called \u2018Hinduism\u2019. The first section of the book describes issues relating to language, dress, diet and festivals, as well as traditions and customs that form an integral part of Hindus living anywhere in the world. The second section deals with issues relating to health care. Chapter 5 (marriage and family life) is the most important chapter for clinicians working in sexual and reproductive health since it focuses on marriage, family structure, sex, contraception, abortion, infertility and adoption"}],"container-title":["Journal of Family Planning and Reproductive Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1783\/147118909787072234","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T20:22:01Z","timestamp":1757103721000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1783\/147118909787072234"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,1]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2009,1,1]]},"published-print":{"date-parts":[[2009,1]]}},"alternative-id":["10.1783\/147118909787072234"],"URL":"https:\/\/doi.org\/10.1783\/147118909787072234","relation":{},"ISSN":["1471-1893","2045-2098"],"issn-type":[{"type":"print","value":"1471-1893"},{"type":"electronic","value":"2045-2098"}],"subject":[],"published":{"date-parts":[[2009,1]]}}}