Placement of laminaria tents does not improve time to delivery in patients undergoing second trimester labor induction with misoprostol.
OBJECTIVE
We sought to determine whether placement of laminaria tents improve time to delivery compared with misoprostol alone in second trimester labor induction.


METHODS
We retrospectively reviewed all patients undergoing second trimester labor induction. Patients with ruptured membranes, abruption, cervical dilation and chorioamnionitis at presentation were excluded. Complications were defined as chorioamnionitis, retained placenta or other surgical procedures. Patients who received laminaria and vaginal misoprostol, 200 microg every 12 h, were compared to those who received misoprostol without laminaria.


RESULTS
Forty-three patients met inclusion criteria, 19 underwent induction with misoprostol alone and 24 with laminaria and misoprostol. The median times to fetal and placenta deliveries were 16.4 and 0.0 h in the misoprostol group, and 20.6 and 0.2 h in the laminaria group. There was no difference in complications. Post-hoc power analysis revealed >80% power to detect a difference in time to delivery of >12 h, and >90% power to detect a difference in time to placental delivery of > or =30 min.


CONCLUSIONS
Placement of laminaria does not improve fetal or placental delivery times in patients undergoing second trimester pregnancy termination by labor induction.
Thornburg
Loralei L
LL
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Strong Memorial Hospital, University of Rochester, Rochester, NY 14642, USA. loralei_thornburg@urmc.rochester.edu
Grace
Daniel
D
Gray
Angela L
AL
Glantz
J Christopher
JC
Pressman
Eva K
EK
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D007795:Laminaria; D016595:Misoprostol / Q000008:administration & dosage; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol