الفهرس 
INDUCTION OF LABOROnly 14 pages are availabe for public view
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Abstract
M
echanical methods used for induction of labor received a great attention nowadays due to the serious side effects of the pharmacological methods. Hygroscopic dilators are considered important subtype of these mechanical methods. One of them is Laminaria which is a synthetic type of sea algae that induces cervical dilation by absorbing water from the cervix and gradually increasing in thickness.
To compare the effectiveness and safety of Laminiria tents to intravaginal prostaglandins for cervical ripening in induction of labor at term gestation in women with unfavorable cervix.
A total of 90 pregnant women at term gestation with unfavorable cervix admitted to the labor ward for induction of labor at Ain Shams University Maternity Hospital, in the period from March 2022 to March 2023, were enrolled in the study and underwent assessment using Bishop score with monitoring differences between two groups in mode of delivery, time to enter active phase, time to delivery, changes in bishop score and noted complications. This study was registered on clinicaltrials.gov with number (NCT06151925)
In the present study we demonstrated that in laminaria group, there was 66.7% had NVD and 33.3% had CS while in prostaglandin group, there was 71.1% had NVD and 28.9% had CS in which there was no statistically significant difference between laminaria and prostaglandin groups regarding routes of delivery. In this study we demonstrated that Time needed to enter active phase (hours) in laminaria group was 16 (10 – 19) while in prostaglandin group was12 (8 – 16) in which there was a statistically significant difference between laminaria and prostaglandin groups regarding Time needed to enter active phase (hours) (p = 0.022). In this study we demonstrated that regarding induction delivery time (hours) in laminaria group was 20 (13 – 25) while in prostaglandin group was 16 (11 – 20) in which there was a statistically significant difference between laminaria and prostaglandin groups regarding induction delivery time (hours) (P=0.036).
CONCLUSION
V
aginal prostaglandin is more effective than laminaria tent for ripening of cervix before induction and can decrease labor duration and time to delivery. However, for better results further studies with a larger sample size are recommended.
RECOMMENDATIONS
• We recommend that in future studies combined methods such as laminaria and misoprostol be compared to reduce side effects and increase the efficacy of interventions.
• Our sample consisted of both primi- and multiparas. Since parity may play a role in cervical ripening and response to induction with oxytocin, we recommend that in future studies this variable be considered, and sample size be increased to provide comparisons in both primi- and multiparas.
• We recommend more studies to examine side effects of vaginal prostaglandin on fetus and mothers during early postpartum.
• Since we applied a low dosage of vaginal prostaglandin, further study on the use of vaginal prostaglandin with higher dosage on primiparas is a good path for the continuing research in this subject.