Abstract

PIP: Laminaria was used as an adjunct to indicate induction of labor in a select population of patients with differing maternal or fetal factors demanding delivery in the face of an uninducible cervix. The study group was made up of inpatients on the maternal-fetal special-care unit who had been scheduled for induction prior to enrollment in the study by the attending physician because of maternal indications. Patients were randomly allocated to either the laminaria group or the control group. Patients in the laminaria group underwent intracervical placement of 6-10 size 6B laminara tents. Retention of laminaria was encouraged by placement of a small Betadine-impregnated vaginal gauze pack. Control patients underwent the same procedure except for placement of laminaria. The use of laminaria effected a significant increase in Bishop score from 2.3 + or - 0.4 to 6.3 + or - 0.9. Baseline Bishop scores were not different between the 2 groups nor did sham treatment result in a significant change in Bishop score. Meaningful comparison of the course of labor between the control and laminaria groups is a problem as there were only 7 vaginal deliveries among the 12 patients. Laminara tents are effective in increasing the apparent inducibility of the unripe cervix at or near term and appear safe and useful in selected patients.