Comparative Study of Cervical Laminar Tents prior to Extra-Amniotic Injection of Ethacridine Lactate (Rivanol) and a Condom-Nelathon Catheter Method for Second-Trimester Pregnancy Interruption in Vietnam

Abstract

Objective: To determine whether the regimen for termination of second-trimester pregnancies using laminaria tents 12–24 h prior to extra-amniotic ethacridine lactate (Rivanol) instillation, is more effective in shortening the insertion-expulsion interval than the presently used method of abortion induction by a condom/Nelathon catheter. Design: A prospective randomised comparative study was performed at Uong Bi General Hospital in Quang Ninh Province, Vietnam, on 91 women undergoing pregnancy termination in the second trimester. Interventions: The subjects were randomly allocated to 2 treatment groups, receiving either the Nelathon catheter-condom method (n = 50) or by insertion of a laminaria tent into the cervical canal for preinduction, 13–29 h before extra-amniotic instillation of ethacridine lactate (n = 34). Seven subjects were not pretreated with the laminaria tent. Main Outcome Measures: The insertion-expulsion intervals and the incidence of side effects were assessed. Results: The mean insertion-expulsion interval in the 2 groups was not significantly different (mean 27.5 ± 16.1 and 26.4 ± 16.4 h, respectively), calculating the insertion-expulsion interval from the start of active treatment, i.e. from the instillation of Rivanol or insertion of the Nelathon catheter and condom, until expulsion of the fetus. Conclusions: The laminaria-Rivanol method for pregnancy interruption is not more advantageous than the existing Nelathon catheter-condom method. Simple, successful and cost-effective methods in achieving second-trimester abortion in the Vietnamese context have therefore to be identified and tested.