Mifepristone versus laminaria: a randomized controlled trial of cervical ripening in midtrimester termination.
BACKGROUND
Mifepristone was compared with laminaria for cervical ripening in second-trimester induction of labor (IOL).


METHODS
We performed a randomized, controlled, open-label study of women undergoing second-trimester IOL for fetal demise, aneuploidy or anomalies at a single tertiary care center from January 2004 to May 2006. Main outcome measures were induction-to-delivery time and pain with cervical ripening.


RESULTS
Of 50 eligible women, 37 were enrolled in the study, of whom 33 completed the study: 16 were randomized to laminaria and 17 to mifepristone. Induction-to-delivery time was significantly shorter in the mifepristone arm (mean=10 h vs. 16 h, p=.01; median=7.5 h vs. 13.4 h, p=.01). Pain with cervical ripening was also significantly less in the mifepristone group than in the laminaria group (median=1 vs. 6 on an 11-point visual analogue scale, p<.001). Maternal age, parity, gestational age, fetal demise prior to induction, need for postpartum curettage, blood loss, pain during induction, delivery and at the time of discharge were not significantly different between the two groups.


CONCLUSIONS
Mifepristone shortens the induction-to-delivery time and decreases pain with cervical ripening when compared with laminaria for second-trimester induction.
Prairie
Beth A
BA
Department of Obstetrics & Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. beth.prairie@dartmouth.edu
Lauria
Michele R
MR
Kapp
Nathalie
N
Mackenzie
Todd
T
Baker
Emily R
ER
George
Karen E
KE
D000021:Abortifacient Agents, Steroidal / Q000009:adverse effects; D000028:Abortion, Induced / Q000379:methods; D000328:Adult; D020070:Cervical Ripening; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D007795:Laminaria; D015735:Mifepristone / Q000009:adverse effects; D016595:Misoprostol; D010146:Pain / Q000209:etiology; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D013997:Time Factors
D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone