Complications caused by difficult removal of laminaria tents

Abstract

2 cases of difficulty in removing laminaria tents which resulted in complications are presented. The first case involved a 15-year-old girl undergoing a therapeutic abortion. The laminaria tent was properly placed into the cervical canal without difficulty but could only be removed during hysterotomy. Only slivers could be recovered with instruments before hysterotomy. The second case involved a 38-year-old woman, gravida 5, para 4, in whome the laminaria tent was also inserted easily. Attempts at removing the tent under direct visualization resulted in the disintegration of the distal end of the tent. The cervix was dilated and the tent was finally caught into a large loop curette and retrieved. Suction curettage was then carried out. The patient had to return to the hospital because of infection due to unrecovered fragments of the contaminated laminaria tent. The difficulty of removal of the tent in both cases was due to an "hourglass" effect which was created. The distal and proximal ends of the tent expanded to a larger diameter than the central portion, which was compressed by the cervical canal.