The contribution of laminaria placement for cervical ripening in second trimester termination of pregnancy induced by intra-amniotic injection of prostaglandin F(2)alpha followed by concentrated oxytocin infusion

Abstract

Objective: Our purpose was to determine whether intracervical placement of laminaria stalks would improve the effectiveness of inducing termination of pregnancies in the second trimester by intra-amniotic injection of prostaglandin F(2)alpha.

Study design: This is a prospective randomized clinical trial conducted at Gynecology Department, Lis Maternity Hospital. Fifty women admitted for indicated second trimester pregnancy termination were randomly assigned to receive either intracervical placement of laminaria (n = 25) or not (n = 25), with concurrent use of intra-amniotic injection of prostaglandin F(2)alpha and concentrated oxytocin. The outcome measures were: time from induction to delivery and the side effects and complications of treatment.

Results: There was no significant difference in the mean interval from induction to delivery in the laminaria and no laminaria groups, being 20 +/- 1.3 (8-30) h versus 19 +/- 1.0 (8-26) h, respectively. In addition, this interval was not different in subgroups of primiparas or multiparas. Other outcome measures such as retained placenta (4% in both groups), post-partum hemorrhage (4% in both groups) gastro-intestinal side effects, fever, and use of analgesia were not significantly different between both groups.

Conclusion: We found no additional value in placing laminaria stalks when using intra-amniotic injection of prostaglandin F(2)alpha followed by concentrated oxytocin infusion for second trimester termination of pregnancy.