Laminaria dilatation and evacuation for pregnancies with mid-trimester premature rupture of membranes: a retrospective cohort study.
OBJECTIVE
To assess the efficacy and risk of chorioamnionitis with laminaria tents and uterine evacuation in patients with mid-trimester premature rupture of membrane (MPROM).


METHODS
A retrospective cohort study of 34 women, admitted between January 1995 and May 1999 with confirmed mid-trimester (14-23 weeks) PROM and 34 controls matched for gestational age, undergoing elective termination. All women underwent cervical dilatation by the use of laminaria tents followed by uterine evacuation (D approximately equals E). Perioperative complications were retrieved from the medical records and long-term ones by telephone questionnaire.


RESULTS
Apart from one case requiring a change in antibiotic, no short- or long-term complications were reported. Although, in 8 out of 19 study cases (42%) endocervix culture was positive. The number of laminaria tents used was similar in both groups. The future pregnancy rate was higher in the study group but included four early spontaneous abortions and one ectopic pregnancy.


CONCLUSIONS
Evacuation of uterus following cervical dilatation by laminaria tents in patients presenting with MPROM is safe, and probably not associated with future adverse pregnancy outcome.
Halperin
R
R
Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, 70300, Zerifin, Israel. ibukovsky@asaf.health.gov.il
Zimmerman
A
A
Langer
R
R
Bukovsky
I
I
Schneider
D
D
D000028:Abortion, Induced; D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000453:epidemiology; D015331:Cohort Studies; D004107:Dilatation and Curettage; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006801:Humans; D007431:Intraoperative Complications; D007795:Laminaria; D011183:Postoperative Complications; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors