Cervical preparation with laminaria tents improves induction-to-delivery interval in second- and third-trimester medical termination of pregnancy

Abstract 

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.

Study

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).

Conclusion

Cervical preparation with laminaria tents significantly shortens the duration of medical TOP that uses mifepristone–misoprostol without adverse events or serious complications.

Keywords: Abortion, Laminaria, Mifepristone, Misoprostol, Termination of pregnancy