Effect of misoprostol versus laminaria tent on cervical ripening in cases of mid-trimester fetal demise

Abstract EN

This is a randomized clinical study to evaluate safety and efficacy of Misoprostol administered orally and vaginally compared to endocervical application of Laminaria tent for management of mid-trimester fetal demise.

It was conducted at the Ob/Gyn.

Department Al Azhar University Hospitals on 45 prime gravida patients with mid-trimester fetal demise during a period of one year started October, 2000.

The cases were randomly divided into three groups 15 each.

For group I, Misoprostol 200|ig tablet was given orally every 6 hours for 24 hours, or vaginally in group II.

While for group III Laminaria tent was applied into the cervix.

Cervical effacement of 50% and 3cm dilatation considered as been the cut off point for cervical ripening (Phase-1) at which the process of termination was augmented and accelerated by using oxytocin titration drip in 5% glucose (Phase-2).

Cervical ripening was statistically significant in group II after 6 hours ( 86.6%) and (66..5 %), (20.1%) in group I and III respectively.

The mean induction - expulsion time interval was 13.2 ± 6.6 hours, 8.13 ± 4.5 hours and 21.6 ± 7.09 hours in group I, II and III respectively.

According to the obtained results it could be concluded that Misoprostol gives better results in termination of mid trimester missed abortion when used vaginally and of lesser effect when used orally.

On the other hand Laminaria found to be the least effective cervical priming agent when compared to misoprostol oral and vaginal.

From this study it be concluded that the two-phase regimen for termination of pregnancy in cases of second trimester fetal demise found to be safe, effective and less costing.