title: Laminaria tent versus Misoprostol for cervical ripening before surgical process in missed abortion.
abstract: OBJECTIVE
  To compare the efficacy of Laminaria tents with Misoprostol for cervical ripening before surgical process in missed abortion.
  
  
  METHODS
  In a prospective study, 70 women with missed abortion were assigned to have either insertion of a 3 mm intracervical Laminaria tent (n = 35) or vaginal Misoprostol 400 μg (n = 35) on the day prior to suction dilation and curettage (D/C). The women were interviewed just prior to the D/C with regard to pain, vaginal bleeding, and cervical dilator preference.
  
  
  RESULTS
  Cervical dilation was greater in the Laminaria group but not significantly different from that in the Misoprostol group. However, additional cervical dilation before D/C was required in more patients in the Misoprostol group (45.7 vs 14.3%, P = 0.001). Women who received Laminaria reported significantly more pain at the time of insertion (62.8% in Laminaria group vs 22.8% in Misoprostol group) compared with women who received Misoprostol. Conversely, Misoprostol was associated with more nausea, vomiting, diarrhea and vaginal bleeding.
  
  
  CONCLUSIONS
  Laminaria tents are more effective cervical dilators than vaginal Misoprostol when inserted the day prior to suction D and C. Vaginal Misoprostol insertion is more comfortable, although it is associated with an increased risk of vaginal bleeding.
authors.affiliation: Research and Clinical Center for Infertility, Shahid Sedughi University of Medical Sciences and Health Service, Yazd, Iran. dr_firouzabadi@ssu.ac.ir
authors.forename: Raziah Dehghani
authors.initials: RD
authors.lastname: Firouzabadi
authors.forename: Leila
authors.initials: L
authors.lastname: Sekhavat
authors.forename: Afsar
authors.initials: A
authors.lastname: Tabatabaii
authors.forename: Sedighah
authors.initials: S
authors.lastname: Hamadani
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000030:Abortion, Missed / Q000139:chemically induced; D000282:Administration, Intravaginal; D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects*; D003967:Diarrhea / Q000139:chemically induced; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D007747:Labor Stage, First / Q000187:drug effects; D007795:Laminaria; D016595:Misoprostol / Q000009:adverse effects / Q000627:therapeutic use*; D009325:Nausea / Q000139:chemically induced; D010146:Pain / Q000139:chemically induced; D011247:Pregnancy; D014592:Uterine Hemorrhage / Q000139:chemically induced; D014839:Vomiting / Q000139:chemically induced; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol