Document Detail


Pre-evacuation dilatation of the pregnant uterine cervix by Laminaria japonica.
MedLine Citation:
PMID:  3473427     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Laminaria japonica was used as pre-dilator of the pregnant uterine cervix prior to termination of pregnancy in the first and second trimester. In the first trimester (6-11 weeks, n=26) no other method was used, while in the second trimester pharmacological stimulation--prostaglandin F2 alpha or the prostaglandin analogue Sulprostone was used after or simultaneously with the laminaria insertion (12-18 weeks n=34 and 40, respectively). The dilatatory effect of laminaria was an obvious help in termination of both first and second trimester pregnancies.
Premature labor is a serious problem in Hungary where it often comes about after the cervix has been injured by a previous 1st or 2nd trimester induced abortion. The incidence of such abortions in high because with girls in the 15- to 19-year age group the 1st pregnancy is often not wanted. In the past the usual methods of dilating the cervix were either a rapid surgical dilatation or intraamniotic injection of prostaglandins to cause violent uterine contractions. Both of these methods caused lacerations of the cervix often resulting in permanent cervical incompetence. What was needed was a method of inducing smooth, slow, gentle dilatation of the uterine cervix. Such a method is the use of laminaria tents made from the seaweed Laminaria japonica, which, when dried, has the capability of absorbing water and slowly expanding. For a 1st trimester abortion 1 medium-sized laminaria is inserted in the morning into the cervical canal to 2-3 mm beyond the internal os. The procedure is repeated 3 hours later. For a 2nd trimester abortion 1 to 3 medium-sized laminarias are inserted and left for 12 hours. Or the laminarias may be inserted and an intraamniotic injection of prostaglandin F given at the same time. The cervical dilation achieved by the laminaria is always greater than the size of the swelled, wet laminaria. Complications of the method, such as displacement of the laminaria into the vagina or into the uterus, impactment of laminaria in the cervix, or infection, are rare if the laminaria are carefully placed parallel to each other and are properly sterilized if reused.
Authors:
J Herczeg; M Sas; J Szabó; G Vajda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta medica Hungarica     Volume:  43     ISSN:  0236-5286     ISO Abbreviation:  Acta Med Hung     Publication Date:  1986  
Date Detail:
Created Date:  1987-06-26     Completed Date:  1987-06-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8400269     Medline TA:  Acta Med Hung     Country:  HUNGARY    
Other Details:
Languages:  eng     Pagination:  145-54     Citation Subset:  IM; J    
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal
Abortion, Induced / methods*
Dilatation / methods
Dinoprost
Dinoprostone* / analogs & derivatives*
Female
Humans
Laminaria*
Pregnancy
Pregnancy Trimester, First
Pregnancy Trimester, Second
Prostaglandins E, Synthetic
Prostaglandins F
Seaweed*
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Prostaglandins E, Synthetic; 0/Prostaglandins F; 363-24-6/Dinoprostone; 551-11-1/Dinoprost; 60325-46-4/sulprostone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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