Cervical preparation with laminaria tents improves induction-to-delivery interval in second- and third-trimester medical termination of pregnancy.
BACKGROUND
The purpose of our study was to determine whether cervical preparation with laminaria tents would improve the procedure of second- and third-trimester medical termination of pregnancy (TOP) in terms of duration of abortion and hospitalization.


METHODS
A retrospective comparative study of two historical periods of women undergoing second- and third-trimester medical TOP at a single tertiary care center from September 2004 to December 2006 was conducted. During Period A, patients received oral mifepristone and vaginal misoprostol, while during Period B, laminaria tents were added. Main outcome measures included initiation-to-delivery (ITD) time, induction-to-delivery interval and hospitalization time.


RESULTS
Of 186 eligible women, 174 were enrolled in the study: 91 patients during Period A and 83 patients during Period B. The ITD time was reduced during Period B compared to Period A (43.2+/-6.2 h and 48.5+/-13.2 h, respectively; p=.001). Similarly, the induction-to-delivery interval was significantly shorter during Period B (7.5 h) compared to Period A (12.7 h; p=.001). A significant reduction in total hospital stay was observed during Period B (3 days) versus Period A (4 days; p<.001).


CONCLUSIONS
Cervical preparation with laminaria tents significantly shortens the duration of medical TOP that uses mifepristone-misoprostol without adverse events or serious complications.
Mazouni
Chafika
C
Department of Obstetrics and Gynecology, Marseille Public Hospital System (APHM), 13385 Marseille, France.
Vejux
Nadège
N
Menard
Jean-Pierre
JP
Bruno
Aurore
A
Boubli
Léon
L
d'Ercole
Claude
C
Bretelle
Florence
F
D000019:Abortifacient Agents; D000328:Adult; D005260:Female; D006801:Humans; D007751:Labor, Induced; D007795:Laminaria; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
D000019:Abortifacient Agents