Comparison of the Effect of Vaginal Misoprostol with and Without Laminaria on Ripening or Cervical Preparation in the Second Trimester Abortion: A Randomized Clinical Trial Study

Background: Therapeutic abortion in the second trimester of pregnancy is the treatment of choice in cases such as severe anomalies or fetal death, and both medical and mechanical methods are used to prepare the cervix. One of the various medical methods is the use of misoprostol (Miso) and one of the various mechanical methods is the use of laminaria (Lam). Objectives: This study aimed to compare the use of Miso alone and its combination with Lam in therapeutic abortion in the second trimester of pregnancy. Methods: In this clinical trial study, pregnant women between 14 and 20 weeks of gestation who were admitted to Ali-Ibn Abitaleb Hospital in Zahedan from July 2019 to September 2020 and were candidates for pregnancy termination due to severe anomalies or fetal death were investigated. After obtaining consent, patients were randomly divided into two groups of 45 receiving Miso alone and Miso + Lam. Then, in addition to demographic variables, the number of hospitalization days, the need for curettage, blood transfusions, analgesics, and the symptoms and complications of drugs were investigated. Results: In this study, none of the demographic factors were significantly different between the two groups (P > 0.05). However, the need for curettage (P = 0.05), labor time (P = 0.04), and hospitalization days (P = 0.003) in the Miso + Lam group were less than the group of Miso alone. Conclusions: Our results showed that curettage cases, labor duration, and length of hospital stay decreased in the Miso + Lam group.