The contribution of laminaria placement for cervical ripening in second trimester termination of pregnancy induced by intra-amniotic injection of prostaglandin F(2)alpha followed by concentrated oxytocin infusion.
OBJECTIVE
Our purpose was to determine whether intracervical placement of laminaria stalks would improve the effectiveness of inducing termination of pregnancies in the second trimester by intra-amniotic injection of prostaglandin F(2)alpha.


METHODS
This is a prospective randomized clinical trial conducted at Gynecology Department, Lis Maternity Hospital. Fifty women admitted for indicated second trimester pregnancy termination were randomly assigned to receive either intracervical placement of laminaria (n = 25) or not (n = 25), with concurrent use of intra-amniotic injection of prostaglandin F(2)alpha and concentrated oxytocin. The outcome measures were: time from induction to delivery and the side effects and complications of treatment.


RESULTS
There was no significant difference in the mean interval from induction to delivery in the laminaria and no laminaria groups, being 20 +/- 1.3 (8-30) h versus 19 +/- 1.0 (8-26) h, respectively. In addition, this interval was not different in subgroups of primiparas or multiparas. Other outcome measures such as retained placenta (4% in both groups), post-partum hemorrhage (4% in both groups) gastro-intestinal side effects, fever, and use of analgesia were not significantly different between both groups.


CONCLUSIONS
We found no additional value in placing laminaria stalks when using intra-amniotic injection of prostaglandin F(2)alpha followed by concentrated oxytocin infusion for second trimester termination of pregnancy.
Almog
Benny
B
Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel. benny118@hotmail.com
Levin
Ishai
I
Winkler
Nurit
N
Fainaru
Ofer
O
Pauzner
David
D
Lessing
Joseph B
JB
Gamzu
Ronni
R
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000028:Abortion, Induced; D000328:Adult; D000650:Amnion; D000698:Analgesia; D020070:Cervical Ripening; D015237:Dinoprost / Q000008:administration & dosage*; D005260:Female; D020567:Fetal Weight; D006801:Humans; D007795:Laminaria; D008875:Middle Aged; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D013997:Time Factors
D000020:Abortifacient Agents, Nonsteroidal; D010120:Oxytocics; D010121:Oxytocin; D015237:Dinoprost