Placement of laminaria tents does not improve time to delivery in patients undergoing second trimester labor induction with misoprostol

Abstract

Objective. We sought to determine whether placement of laminaria tents improve time to delivery compared with misoprostol alone in second trimester labor induction.Methods. We retrospectively reviewed all patients undergoing second trimester labor induction. Patients with ruptured membranes, abruption, cervical dilation and chorioamnionitis at presentation were excluded. Complications were defined as chorioamnionitis, retained placenta or other surgical procedures. Patients who received laminaria and vaginal misoprostol, 200 μg every 12 h, were compared to those who received misoprostol without laminaria.Results. Forty-three patients met inclusion criteria, 19 underwent induction with misoprostol alone and 24 with laminaria and misoprostol. The median times to fetal and placenta deliveries were 16.4 and 0.0 h in the misoprostol group, and 20.6 and 0.2 h in the laminaria group. There was no difference in complications. Post-hoc power analysis revealed >80% power to detect a difference in time to delivery of >12 h, and >90% power to detect a difference in time to placental delivery of ≥30 min.Conclusions. Placement of laminaria does not improve fetal or placental delivery times in patients undergoing second trimester pregnancy termination by labor induction.