ISSN 2149-2247 | E-ISSN 2149-2549
1 Department of Obstetrics and Gynecology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey  
2 Department of Obstetrics and Gynecology, Erciyes University Faculty of Medicine, Kayseri, Turkey  
Erciyes Med J ; : -


Objective: We aimed to compare the efficacies of laminaria, vaginal misoprostol, and mechanical dilator applications before surgical intervention with regard to the optimal cervical dilation and severity of pain in first-trimester pregnant women with missed abortion.


Material and Method: The prospective study included a total of 103 patients with a diagnosis of missed abortion in the 6th-10th gestational week randomly divided into 3 groups for application of 400 µg vaginal misoprostol,  laminaria or mechanical dilators for dilation of the cervix before surgical intervention. The effects of laminaria and vaginal misoprostol on the cervical ripening for surgical intervention were evaluated with the Hegar test. Visual analog scale (VAS) values were evaluated during the first application, throughout the period of their applications and after the surgical intervention.


Results: The cervical dilation was found to be similar in the laminaria and vaginal applications (p=0.64). During the first application, laminaria caused more pain than misoprostol but the difference was not reached statistical significance (p=0.28). Throughout the period of application and after the surgical intervention, although there was less pain in respect of VAS values after laminaria application, this was not reached statistical significance (p=0.11). The VAS values after the surgical intervention was determined to be statistically higher after mechanical dilatation compared to other procedures (p=0.001).


Conclusion: Laminaria provides cervical preparedness as intracervical misoprostol without increasing side effects in the management of first-trimester pregnant women with missed abortion. 

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