Laminaria

Laminaria is dried seaweed in the shape of a small pen that has been sterilized. This material has the ability to absorb moisture which allows the cervix to open up and become soft. It is used in the first and second trimester and late term abortions to reduce the incidence of cervical tears, uterine perforation (hole in uterine wall), retained gestational tissue and excessive bleeding. Thus reducing the incidence of infection, hospitalizations, bowel injury, hysterectomy, blood transfusions, and maternal death.

For patients in the first trimester and early second trimester, one or several Laminaria placed through the cervix and retained there for three to four hours, is usually enough time to allow for adequate opening and softening of the cervix to occur in patients up to 16 weeks gestation. This allows safe removal of the pregnancy tissue. In patients 16 weeks or further, the Laminaria may need to remain in the cervix over night to allow for further dilation (opening) of the cervix to occur and the tissue can be removed the next day. It is not uncommon for it to take a second day of removal of the original Laminaria, replace them with more and not remove the fetal tissue until the third day. This allows more softening and dilatation of the cervix to take place.

Second day insertion of Laminaria has become less common since combining with Misoprostol which allows most pregnancy tissue to be removed on the second day of the abortion procedure.

Laminaria are generally safe. Complications are rare but include infection, breaking off inside the uterus, perforation of the uterus. The most common side effect of Laminaria is lower abdominal cramping which is due to the opening and softening of the cervix. 

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