Laminaria and sulprostone in second trimester pregnancy termination for fetal abnormalities

Abstract

The efficacy and safety of intracervical placement of laminaria and intravenous prostaglandin E2 (sulprostone) infusion for termination of second-trimester pregnancies with abnormal fetuses was investigated. One hundred and six pregnant women at 13-29 weeks' gestation with fetal anomalies underwent laminaria tent insertion into the cervical canal on admission. The next morning, Sulprostone infusion was started at a rate of 16 microg/h and increased by 16 microg/h every 30 min to induce uterine contractions. Induction-to-abortion time (IAT), success and complete abortion rates, and sulprostone-related side effects were registered. The overall success and complete abortion rates within 24 h were 91.5 and 80.2%, respectively. The mean IAT was 12.1+/-7.6 h. The incidence of nausea and/or vomiting was 17.9%, with 1.7 episodes per case. Diarrhea and fever (9.5%) were not common. Laminaria tent insertion plus sulprostone infusion was an effective and safe regimen for second-trimester termination of pregnancy with live fetuses.

The results of using the combination of letrozole and misoprostol in comparison with laminaria and misoprostol in preparing the cervix for miscarriages under the second trimester of pregnancy

“…Among the medicinal methods, one of the methods is the use of misoprostol, which softens the cervix and induces labor pains in the second trimester of pregnancy. 15 One of the mechanical methods is to use devices that slowly dilate the cervix. Ghung et al concluded that the low price, easy insertion method and the ability to remove it quickly are the benefits of laminaria, and this method can be used in abortion treatment in the second trimester.…”

“…16 Slow and gradual dilatation of the cervix by laminaria before the beginning of the medical induction of labor reduces the risk of wound and trauma to the cervix. 15,17 Due to the different results in different studies and emphasizing the point that laminaria is a cheap medicine, it has few complications for the patient and also reduces the possibility of trauma to the cervix in patients who are candidates for abortion treatment, we decided to investigate the effects of the medicinal combination of laminaria and Let's compare vaginal misoprostol with letrozole + misoprostol in preparation of cervix in second trimester abortion.…”