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Laminaria Insertion

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1. Paracervical Block for Laminaria Insertion Before Second-Trimester Abortion: A Randomized Controlled Trial

Paracervical Block for Laminaria Insertion Before Second-Trimester Abortion: A Randomized Controlled Trial To evaluate the efficacy of a paracervical block to decrease pain during osmotic dilator insertion before second-trimester abortion.In this double-blind, randomized trial, 41 women undergoing Laminaria insertion before a second-trimester abortion received either a paracervical block with 18 mL 1% lidocaine and 2 mL sodium bicarbonate or a sham block. Women were between 14 and 23 6/7 weeks (...) of gestation. The primary outcome was pain immediately after insertion of Laminaria. Women assessed their pain on a 100-mm visual analog scale. Secondary outcomes included assessment of pain at other times during the insertion procedure and overall satisfaction with pain control. To detect a 25-mm difference in pain immediately after Laminaria insertion, at an α of 0.05 and 80% power, we aimed to enroll 20 patients in each arm.From May 2015 to December 2015, 20 women received a paracervical block and 21

2017 EvidenceUpdates

2. Laminaria Insertion

Laminaria Insertion Laminaria Insertion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Laminaria Insertion Laminaria Insertion Aka (...) : Laminaria Insertion , Laminaria , Laminaria digitata , Dilateria , Lamicel , Dilapan II. Indications Cervical dilation prior to III. Advantages Safe and effective Less cervical and pain than with dilator IV. Preparations Laminaria digitata Seaweed stem of 2-3 mm width String attached to end for removal Swells on contact with water May reach up to 5x its original width in 12 hours Synthetic alternatives to Laminaria Dilateria Lamicel Dilapan V. Procedure Prepare Expose with medium Graves speculum Use

2018 FP Notebook

3. Paracervical Block for Pain Associated With Laminaria Insertion

Paracervical Block for Pain Associated With Laminaria Insertion Paracervical Block for Pain Associated With Laminaria Insertion - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Paracervical Block for Pain (...) Associated With Laminaria Insertion The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02454296 Recruitment Status : Completed First Posted : May 27, 2015 Results First Posted : April 14, 2017 Last Update Posted : April 14, 2017 Sponsor: University of Hawaii Information provided by (Responsible Party): Reni

2015 Clinical Trials

4. Prevalence and risk factors of inadequate cervical dilatation following laminaria insertion in second trimester abortion - case control study. (PubMed)

Prevalence and risk factors of inadequate cervical dilatation following laminaria insertion in second trimester abortion - case control study. The objective was to explore the prevalence of and risk factors for inadequate cervical dilation following insertion of a single set of laminaria in women scheduled for dilation & evacuation (D&E) at 14-24 weeks' gestation.We retrospectively reviewed all cases of women who underwent pregnancy termination by D&E at 14-24 weeks' gestation between January (...) insertion, namely, previous cesarean section (p=.002) and previous cervical procedure (p<.001), whereas increased gravidity was found to protect against inadequate cervical dilation (p=.002).Previous cesarean section/s, cervical procedures and primigravidity were found to be risk factors for failure to achieve adequate cervical dilation after a single set of laminaria. Women who are scheduled for D&E, and in whom one of these risk factors exists, might benefit from additional interventions to achieve

2015 Contraception

5. Intrauterine lidocaine for pain control during laminaria insertion: a randomized controlled trial. (PubMed)

Intrauterine lidocaine for pain control during laminaria insertion: a randomized controlled trial. To determine if intrauterine administration of 5 cc of 2% lidocaine in addition to paracervical block reduces pain during laminaria insertion, when compared with paracervical block and saline placebo.This was a randomized, double blind placebo-controlled trial. Women presenting for abortion by dilation and evacuation (D&E) at 14-24 weeks gestational age were randomized to receive an intrauterine (...) instillation of either 5 mL of 2% lidocaine or 5 mL of normal saline, in addition to standard paracervical block with 20 cc of 0.25% bupivacaine. Our primary outcome was self-reported pain scores on a 100mm Visual Analogue Scale (VAS) immediately following laminaria insertion. Secondary outcome was self-reported VAS pain score indicating the maximum level of pain experienced during the 24-48-h interval between laminaria insertion and D&E procedure.Seventy-two women were enrolled, and data for 67 women were

2014 Contraception

6. Laminaria and Misoprostol Before Operative Hysteroscopy

: December 20, 2017 Estimated Primary Completion Date : December 2018 Estimated Study Completion Date : January 2019 Resource links provided by the National Library of Medicine available for: Arms and Interventions Go to Arm Intervention/treatment Experimental: Laminaria Laminaria tent was introduced in the cervical canal Device: Laminaria tent Laminaria tent was inserted for 12 hours before Hysteroscopy Active Comparator: Laminaria plus Misoprostol Laminaria and Misoprostol were introduced Drug (...) : Laminaria plus Misoprostol Laminaria plus Misoprostol were inserted for 12 hours before Hysteroscopy Other Name: cytotec, Outcome Measures Go to Primary Outcome Measures : Preoperative cervical width [ Time Frame: 12 hours ] cervical width in Hegar dilators number Secondary Outcome Measures : adverse effects [ Time Frame: 24 hours ] adverse effects of the method used or hysteroscopy Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study

2017 Clinical Trials

7. Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained Laminaria (PubMed)

underwent an operative hysteroscopy confirming our suspicion for retained laminaria. The pathology report demonstrated chronic severe endometritis and plant based material.Retained laminaria are associated with chronic pelvic pain and chronic infertility. Since they can be difficult to detect on conventional imaging, proper counting prior to insertion and after removal is an essential physician responsibility. (...) Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained Laminaria In 2013, the abortion rate in the United States was found to be 200 abortions per 1,000 live births. Of these, the CDC estimates that nearly 49% were performed using unsafe measures. Even when these procedures are safely performed, patients are at risk for immediate or delayed complications. In second-trimester terminations, mechanical dilation with an osmotic dilator is common to allow for delivery of the fetus

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2017 Case reports in obstetrics and gynecology

8. Laminaria Insertion

Laminaria Insertion Laminaria Insertion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Laminaria Insertion Laminaria Insertion Aka (...) : Laminaria Insertion , Laminaria , Laminaria digitata , Dilateria , Lamicel , Dilapan II. Indications Cervical dilation prior to III. Advantages Safe and effective Less cervical and pain than with dilator IV. Preparations Laminaria digitata Seaweed stem of 2-3 mm width String attached to end for removal Swells on contact with water May reach up to 5x its original width in 12 hours Synthetic alternatives to Laminaria Dilateria Lamicel Dilapan V. Procedure Prepare Expose with medium Graves speculum Use

2015 FP Notebook

9. Laminaria versus vaginal misoprostol for cervical preparation before second trimester surgical abortion: a randomized clinical trial. (PubMed)

to the misoprostol group (12.8 vs. 12.4mm, respectively; p=.32). No difference was demonstrated regarding the need for additional dilation or the difficulty of the procedure. Procedures performed after laminaria insertion were 1 min longer (median 11 vs. 10 min, p=.04). Participants found laminaria placement more uncomfortable than vaginal misoprostol placement. Other than pain, additional side effects occurred only in the misoprostol group, primarily nausea and vomiting. One participant in the misoprostol group (...) experienced fetal expulsion during the night before the intended procedure.Either vaginal misoprostol or laminaria provides adequate dilation for second-trimester surgical abortion. Laminaria causes more pain at insertion and misoprostol causes more side effects.We found that cervical preparation in an inpatient setting for approximately 11h with misoprostol 600 mcg vaginally is comparable to 11h of laminaria. However, given the potential for spontaneous expulsion and more side effects with misoprostol

2015 Contraception

10. A randomized trial of misoprostol versus laminaria before dilation and evacuation in South Africa. (PubMed)

A randomized trial of misoprostol versus laminaria before dilation and evacuation in South Africa. To compare complication rates, efficacy and acceptability of buccal misoprostol to laminaria for cervical preparation before dilation and evacuation (D&E) in South Africa.We performed a randomized, single-blind trial comparing buccal misoprostol 400 mcg (1-2 doses, administered at least 3 h before D&E) to laminaria inserted the day before D&E among women at 13-19 weeks gestation. The primary (...) age was 14.8 weeks (range, 13.0-18.6 weeks). Complications were rare and did not differ by group [three in each group; odds ratio (OR), 1; 95% confidence interval (CI), 0.20-5.11]; this included two expulsions in the misoprostol group (2.6%). Misoprostol participants were more likely to require mechanical dilation compared to those receiving laminaria (35% vs. 8%; OR, 6.4; 95% CI, 2.4-16.5). The proportion of women reporting each side effect was similar except for diarrhea (21.3% in misoprostol

2014 Contraception

11. Insertion of a double balloon catheter for induction of labour in pregnant women without previous caesarean section

Insertion of a double balloon catheter for induction of labour in pregnant women without previous caesarean section Insertion of a double balloon catheter for Insertion of a double balloon catheter for induction of labour in pregnant women without induction of labour in pregnant women without pre previous caesarean section vious caesarean section Interventional procedures guidance Published: 23 July 2015 nice.org.uk/guidance/ipg528 Y Y our responsibility our responsibility This guidance (...) recommendations wherever possible. 1 1 Recommendations Recommendations 1.1 Current evidence on the efficacy and safety of insertion of a double catheter balloon for induction of labour in women without previous caesarean section is © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 9adequate to support the use of this procedure provided that normal arrangements are in place for clinical governance, consent and audit. 2 2

2015 National Institute for Health and Clinical Excellence - Interventional Procedures

12. Randomised controlled trial: Double-balloon catheter results in higher rate of vaginal delivery within 24?h when compared with dinoprostone vaginal insert

Randomised controlled trial: Double-balloon catheter results in higher rate of vaginal delivery within 24?h when compared with dinoprostone vaginal insert Double-balloon catheter results in higher rate of vaginal delivery within 24 h when compared with dinoprostone vaginal insert | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use (...) with dinoprostone vaginal insert Article Text Therapeutics Randomised controlled trial Double-balloon catheter results in higher rate of vaginal delivery within 24 h when compared with dinoprostone vaginal insert Anthony C Sciscione , Kelly Ruhstaller Statistics from Altmetric.com Commentary on: Cromi A , Ghezzi F , Uccella S , et al . Randomised trial of preinduction cervical ripening: dinoprostone vaginal insert versus double-balloon catheter. Context Induction of labour is one of the most common obstetric

2013 Evidence-Based Medicine (Requires free registration)

13. Comparison of Laminaria and Misoprostol for Cervical Preparation Before Second Trimester Surgical Abortion

MedGyn Products, Inc. USA overnight the day before the abortion Device: Laminaria, MedGyn Products, Inc. USA. Insertion of Hygroscopic laminarias into the cervical canal for preparation prior to late surgical abortion. The number of laminarias is according to the cervical compliance. Other Name: laminaria tents Active Comparator: Misoprostol group Patients in this group will have cervical preparation with vaginal Misoprostol 600 mcg overnight the day before the abortion Drug: Misoprostol Cervical (...) preparation with vaginal Misoprostol 600 mcg overnight the day before the abortion Other Name: Cytotec Outcome Measures Go to Primary Outcome Measures : Initial cervical opening and the need for further dilatation at the start of the procedure [ Time Frame: 8-12 hours after insersion of laminaria or Misoprostol ] The surgical abortion will be performed 8-12 hours after the insertion of laminaria, or after vaginal application of Misoprostol Secondary Outcome Measures : pain score during cervical

2012 Clinical Trials

14. Intrauterine Lidocaine for Laminaria

: This is a study to investigate whether instilling a small amount of liquid lidocaine into the uterus will decrease pain felt by women during laminaria insertions done for cervical dilation prior to second trimester abortion. The investigators hypothesize that women who receive intrauterine lidocaine in addition to a paracervical block will experience less pain than women who receive only a paracervical block. Condition or disease Intervention/treatment Phase Abortion, Induced Pain Management Drug: Lidocaine (...) Drug: Normal Saline Phase 1 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 72 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: Intrauterine Lidocaine for Pain Control During Laminaria Insertion Prior to Dilation & Evacuation (D&E) Study Start Date : September 2012 Actual Primary

2012 Clinical Trials

15. Laminaria tent versus Misoprostol for cervical ripening before surgical process in missed abortion. (PubMed)

Laminaria tent versus Misoprostol for cervical ripening before surgical process in missed abortion. To compare the efficacy of Laminaria tents with Misoprostol for cervical ripening before surgical process in missed abortion.In a prospective study, 70 women with missed abortion were assigned to have either insertion of a 3 mm intracervical Laminaria tent (n = 35) or vaginal Misoprostol 400 μg (n = 35) on the day prior to suction dilation and curettage (D/C). The women were interviewed just (...) prior to the D/C with regard to pain, vaginal bleeding, and cervical dilator preference.Cervical dilation was greater in the Laminaria group but not significantly different from that in the Misoprostol group. However, additional cervical dilation before D/C was required in more patients in the Misoprostol group (45.7 vs 14.3%, P = 0.001). Women who received Laminaria reported significantly more pain at the time of insertion (62.8% in Laminaria group vs 22.8% in Misoprostol group) compared with women

2012 Archives of gynecology and obstetrics

16. Laminaria as an adjunct in induction of labor. (PubMed)

Laminaria as an adjunct in induction of labor. The safety and efficacy of laminaria tents as an adjunct to labor induction near term were examined in a prospective, controlled, and randomized study involving insertion of laminaria into the cervical canal the evening prior to planned induction. Six of 35 subjects in whom laminaria were used entered labor spontaneously and delivered overnight, compared with 1 of 39 controls. Of the remainder, the Bishop score increased an average of 3.7 points (...) , a highly significant change, in the laminaria-treated group compared with no change in the controls. Labor, induced primarily by amniotomy with intravenous oxytocin then given to patients in whom regular contractions did not begin within 8 hours, was shorter with laminaria use than in controls, though the amniotomy-to-delivery interval did not differ significantly. However, comparison of the subgroup with cervices relatively unfavorable for induction, indicated by an initial Bishop score of 5 or less

1978 Obstetrics and Gynecology

17. Midtrimester abortion with urea, prostaglandin F2alpha, laminaria, and oxytocin. A new regimen. (PubMed)

a contraindication to the use of prostaglandin. Three infusions were used: prostaglandin alone, urea alone, and a combination of urea and prostaglandin. All patients had pre-infusion laminaria inserted and all received oxytocin following infusion. There was a significant difference in instillation to abortion time when comparing the three groups and a marked reduction in gastrointestinal side effects using a lower dosage of prostaglandin. The synergistic effect of urea and prostaglandin F2alpha, previously (...) Midtrimester abortion with urea, prostaglandin F2alpha, laminaria, and oxytocin. A new regimen. This study was undertaken to determine a method of amino infusion that would 1) produce abortion within 12 hours; 2) be relatively free from risks of coagulapathy and electrolyte imbalance; 3) not result in delivery of liveborns; and 4) incur minimal gastrointestinal side effects from prostaglandin. Patients were randomly assigned to 1 of 3 groups unless history and examination revealed

1978 Obstetrics and Gynecology

18. Prophylactic Lidocaine Spray for Pain Alleviation in Women Undergoing Osmotic Dilator Insertion for Second Trimester Dilatation and Evacuation

to the cervix and after a 2 minute wait laminaria will be inserted. Clinical data will be collected including age, parity, general health, Obstetric and gynecologic history. Primary outcome : difference in pain score immediately after speculum removal and 10 minutes after speculum removal The protocol will not be repeated if a participant is to return for further laminaria insertion. Sample size A sample size was calculated assuming a target difference of 10 (smallest effect of clinical importance) between (...) spray group Drug: Lidocaine will local application of lidocaine to the cervix alleviate pain of laminaria insertion Placebo Comparator: placebo arm Other: placebo comparator Outcome Measures Go to Primary Outcome Measures : Does application of lidocaine to the cervix alleviate pain relative to placebo when inserting laminaria for cervical preparation prior to DE [ Time Frame: pain scores will be assesed immediately following speculum insertion, after speculum withdrawl and fifteen minutes after

2014 Clinical Trials

19. Mifepristone Versus Osmotic Dilator Insertion for Cervical Preparation Prior to Surgical Abortion at 15-18 Weeks

Comparator: Osmotic dilators Placed 20-24 hours prior to procedure Device: osmotic dilators osmotic dilators placed in the cervix 20-24 hours prior to the procedure Other Names: Laminaria Dilapan-S Dilapan Outcome Measures Go to Primary Outcome Measures : Length of Procedure [ Time Frame: Subjects will be followed from the administration of mifepristone/misoprostol or laminaria, until the end of their procedure, a total of two days. ] Interval from speculum insertion to speculum removal Secondary Outcome (...) Mifepristone Versus Osmotic Dilator Insertion for Cervical Preparation Prior to Surgical Abortion at 15-18 Weeks Mifepristone Versus Osmotic Dilator Insertion for Cervical Preparation Prior to Surgical Abortion at 15-18 Weeks - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved

2011 Clinical Trials

20. Mifepristone Versus Laminaria Insertion for Cervical Preparation Prior to Surgical Abortion at 14-16 Weeks

Mifepristone Versus Laminaria Insertion for Cervical Preparation Prior to Surgical Abortion at 14-16 Weeks Mifepristone Versus Laminaria Insertion for Cervical Preparation Prior to Surgical Abortion at 14-16 Weeks - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100 (...) ). Please remove one or more studies before adding more. Mifepristone Versus Laminaria Insertion for Cervical Preparation Prior to Surgical Abortion at 14-16 Weeks (SAMi) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT00986921 Recruitment Status : Completed First Posted : September 30, 2009 Results

2009 Clinical Trials

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