Lamicel is more effective in preparing the cervix for midtrimester termination of pregnancy than Laminaria japonicum.

Abstract

Laminaria tents are often used prior to prostaglandin termination of midtrimester pregnancy to reduce the induction-abortion interval. Natural laminaria suffers from a number of disadvantages and, recently, a synthetic form Lamicel (Cabot Medical, PA), has been produced. Uncontrolled evaluation has suggested that it is effective for dilating the cervix but scepticism remains because Lamicel does not exert radial force on the cervical canal. One hundred women who requested abortion between 12 and 24 weeks of pregnancy were studied. They were randomly divided into group A who had a Lamicel inserted for 6 hours and group B who had a laminaria tent inserted for 8 hours. The cervical dilatation was assessed at the end of this period and the patients were then given up to 6 injections of sulprostone at 4-hourly intervals. All patients in Group A aborted, but 7 of those in Group B did not. The mean cervical dilatation in Group A was 7.47 +/- 1.46 mm compared with 4.71 +/- 1.76 mm in Group B (p less than 0.001). The mean induction-abortion interval in Group A was also significantly shorter (p less than 0.05) than that in Group B: 11.79 +/- 7.24 hours compared with 12.51 +/- 6.52 hours in Group B (excluding 7 patients who failed to abort in Group B). The results of the study suggest that the degree of cervical dilatation that can be achieved using Lamicel is significantly greater than that by laminaria tents.