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  • Title: Synthetic laminaria for cervical dilatation prior to vacuum aspiration in midtrimester pregnancy.
    Author: Brenner WE, Zuspan K.
    Journal: Am J Obstet Gynecol; 1982 Jun 15; 143(4):475-7. PubMed ID: 7091212.
    Abstract:
    Potential benefits of a synthetic tent compared to the natural laminaria japonica would be: 1) uniformly sized and shaped, 2) uniformity of dilatation characteristics, 3) assurance of sterility, 4) less expense, 5) ability to control rate and amount of dilatation, and 6) ability to control shape. 20 healthy women, from 13-17 weeks gestation desiring elective abortion had 1 intracervical laminaria tent placed in the cervix after cervical dilatation was determined. The following day the tent was removed and the amount of dilatation again determined. Abortion was accomplished with dilatation and evacuation; all received oral tetracycline, 250 mg 4 times/day for 4 days. The laminaria tents were highly effective: mean cervical dilatation was 1.4 mm before insertion and 12.8 mm after the tents were removed; with no apparent differences in dilatation among the 8 nulliparous patients compared to the 12 multiparous patients. Further dilatation in 11 women was accomplished with minimal pressure. Several had mild discomfort during laminaria insertion but all attempts were successful without anesthesia. The tents came out of the cervix spontaneously in only 1 patient. There were no cervical tears, false passages, uterine infections, or retained products of conception. Use of synthetic laminaria tents appears practicable for the following reasons: 1) clinically significant dilatation and softening occurred with overnight use, 2) side effects were minimal, 3) no visible tissue reaction occurred, 4) relatively short use (less than 24 hours) lessens possibilities for infection, and 5) the small dose of magnesium sulfate appears safe. Further studies are necessary to determine the incidence of complications, to research use in patients needing cervical dilatation for other purposes, to evaluate laminaria tents with other concentrations of magnesium sulfate and different amounts of compression.
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