Comparison of the Efficacy of Vaginal Misoprostol with and without Laminaria in Second Trimester Induction Abortion

Background & Aims: Therapeutic abortion in the second trimester pregnancy is the choice treatment in cases with severe anomalies or intrauterine fetal death. It can be done by a number of medical (e.g. misoprostol) or mechanical methods (e.g. laminaria). The aim of this study was to compare the efficacy of misoprostol alone and misoprostol in combination with laminaria in the induction of second trimester abortion. Method: In this interventional study, 80 pregnant women with the gestational age of 13-25 weeks who were candidates of therapeutic abortion were selected and randomly divided into two groups (n=40). One group received misoprostol alone and the other received misoprostol in combination with laminaria. Results: Combination of misoprostol and laminaria caused not only a significant shorter time interval from the initiation of intervention to abortion (P=0.034), but also lower dose of administered misoprostol (P=0.001), less need for curettage (P=0.001), and shorter hospitalization period (P = 0.042). Conclusion: Based on the obtained results, misoprostol in combination with laminaria is recommended for the induction of second trimester therapeutic abortion.