The contribution of laminaria placement for cervical ripening in second trimester termination of pregnancy induced by intra-amniotic injection of prostaglandin F2alpha followed by concentrated oxytocin infusion

Almog, Benny; Levin, Ishai; Winkler, Nurit; Fainaru, Ofer; Pauzner, David; Lessing, Joseph B.; Gamzu, Ronni

doi:10.1016/j.ejogrb.2004.04.003

Cited by 11 publications

(4 citation statements)

References 10 publications

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“…A comparable increase in medication use during pregnancy has been described in other populations over recent decades 1–4 . This trend possibly reflects a change in maternal demographics over the years, including an increase in maternal age 3,5,30 . The increase in pre‐pregnancy maternal weight 5 and the heightened prevalence of multimorbidity 31 are other likely contributors to the amplified overall need for medication in pregnancy.…”

Section: Discussionmentioning

confidence: 55%

“… 1 , 2 , 3 , 4 This trend possibly reflects a change in maternal demographics over the years, including an increase in maternal age. 3 , 5 , 30 The increase in pre‐pregnancy maternal weight 5 and the heightened prevalence of multimorbidity 31 are other likely contributors to the amplified overall need for medication in pregnancy. Use of assisted reproduction has become more widespread and the technology has become more successful—also among the older women or women with multimorbidity.…”

Section: Discussionmentioning

confidence: 99%

“…Use of medication during pregnancy has increased over the past decade, 1 , 2 , 3 , 4 likely reflecting changes in maternal demographics, obstetric practice, and medication use in general. 3 , 4 , 5 , 6 , 7 Estimates indicate that use of prescription medication during pregnancy varies from 27% to 93%, 4 , 8 , 9 , 10 , 11 with the total prevalence of medication usage potentially being somewhat higher if over‐the‐counter medications are taken into account. 12 , 13 , 14 , 15 In Denmark, the use of at least one reimbursed medication during pregnancy was 60% among primiparous women in 2009.…”

Section: Introductionmentioning

confidence: 99%

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Use of medication in pregnancy on the rise: Study on 1.4 million Danish pregnancies from 1998 to 2018

Thunbo,

Vendelbo,

Witte

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionMaternal demographics have evolved, and more women than ever enter pregnancy with preexisting comorbidity and with potentially complex medication exposure, including polypharmacy (concomitant intake of multiple medications). This study aims to describe the evolution of medication use in pregnancy in Denmark from 1998 to 2018 with special focus on polypharmacy, patterns of use, and underlying demographics.Material and methodsA Danish nationwide historical registry study based on all clinically recognized pregnancies with a gestation ≥10 weeks between 1998 and 2018. Medication use was estimated by redemption of prescriptions during pregnancy.ResultsAmong a total of 1 402 327 clinically recognized pregnancies, redemption of at least one prescription medication during pregnancy increased from 56.9% in 1998 to 63.3% in 2018, coinciding with an increased use of polypharmacy (from 24.8% in 1998 to 35.2% in 2018). The prevalence of pregnant women who used medications for chronic conditions increased more than the prevalence of women treated for occasional or short‐time conditions. Redemption of one or multiple prescription medications during pregnancy was mostly seen among pregnant women ≥35 years of age. However, pregnant women <25 years old exhibited the largest increase in medication use during the study period.ConclusionsMedication use in general, and polypharmacy in particular, increased from 1998 to 2008, possibly as the result of an increased prevalence of pregnant women with chronic conditions requiring pharmacological treatment. Notably, a marked maternal age‐based discrepancy in usage pattern was observed, highlighting the need for further research in this area. The rise in the prevalence of polypharmacy during pregnancy underscores the need for pharmacovigilance to monitor adverse effects. Future studies should investigate the patterns of polypharmacy and the accompanying maternal and fetal risks.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of medication in pregnancy on the rise: Study on 1.4 million Danish pregnancies from 1998 to 2018

Thunbo,

Vendelbo,

Witte

et al. 2024

Acta Obstet Gynecol Scand

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“…8 Pharmacological techniques mainly include the use of prostaglandin products. [9][10][11] Mechanical techniques are hygroscopic dilators of the cervix. One of the types of hygroscopic dilators is prepared from the stem of Laminaria digitata or Laminaria japonica (brown seaweed), which is placed inside the cervix to induce labor.…”

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confidence: 99%

The results of using the combination of letrozole and misoprostol in comparison with laminaria and misoprostol in preparing the cervix for miscarriages under the second trimester of pregnancy

Sheikham,

Amani

2024

Int J Basic Clin Pharmacol

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Background: 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 and letrozole) or mechanical methods (e.g. laminaria). The aim of this study was to compare the efficacy of vaginal misoprostol with and without letrozole and combination of misoprostol and laminaria for preoperative cervical ripening among women with under second trimester abortion. Methods: In this interventional study, 80 pregnant women in the second trimester pregnancy (Gestational age under 20 weeks) were randomly divided in two groups (n=40). One group received vaginal misoprostol in combination with laminaria and oral placebo and other group received vaginal misoprostol in combination with letrozole. Patients regularly examined every 4 hours and in the absence of abortion, vaginal misoprostol repeated after 4 hours. No report of products of conception abortion considered as complete abortion and the patient discharged. Data collected in a cheklist and then analyzed by statistical methods in SPSS version 21. Results: Complete abortion was reported in 70 (87.5%) of all patients which in group letrozole+misoprostol in 34 (85%) and in laminaria+misoprostol was reported in 36 (90%). 6 (15%) Curettage was reported in group letrozole+misoprostl and 4 (10%) in laminaria+misoprostol and the difference were not statistically significant. Conclusions: Results showed that both of combination are effective in the abortion but misoprostol in combination with laminaria is recommended for the induction of second trimester therapeutic abortion.

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Medical treatment for early fetal death (less than 24 weeks)

Neilson

Hickey

Vázquez³

2006

Cochrane Database of Systematic Reviews

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The contribution of laminaria placement for cervical ripening in second trimester termination of pregnancy induced by intra-amniotic injection of prostaglandin F2alpha followed by concentrated oxytocin infusion

Cited by 11 publications

References 10 publications

Use of medication in pregnancy on the rise: Study on 1.4 million Danish pregnancies from 1998 to 2018

Use of medication in pregnancy on the rise: Study on 1.4 million Danish pregnancies from 1998 to 2018

The results of using the combination of letrozole and misoprostol in comparison with laminaria and misoprostol in preparing the cervix for miscarriages under the second trimester of pregnancy

Medical treatment for early fetal death (less than 24 weeks)

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