Preinduction ripening of the cervix with laminaria in the nulliparous patient

Abstract

Laminaria tents were used to ripen the unfavorable cervices of 45 nulliparas prior to induction of labor. Successful induction of labor was significantly more frequent in this group than in matched controls in whom induction was attempted without prior laminaria application.

PIP: Based on favorable results from a pilot study, this study evaluated cervical ripening by laminaria tents previous to induction in nulliparous patients with unfavorable Bishop scores. 91 nulliparas were studied; 46 were study patients and 45 were maternal age- and gestational age-matched controls. In the study group, 3 or 4 laminaria were inserted beyond the internal cervical os and were removed 12 hours later, at which time Bishop scores were reassessed. Before laminaria treatment, Bishop scores in the 2 groups were not significantly different. After treatment, Bishop scores of the study group changed significantly from 3.3+ or -1.2 before to 6.5+ or -2.2 (P .0005) after laminaria removal. 33 patients were successfully induced in the study group compared with 5 in the control group. 31 of the 33 could deliver vaginally. 4 of the 5 control patients delivered vaginally.