Laminaria tents versus vaginal prostaglandin in cervical ripening in term induction of labor with unfavorable cervix: a randomized controlled trial

ABSTRACT

Objective. To compare the effectiveness and safety of Laminaria tents and intravaginal prostaglandins for cervical ripening in term pregnant women undergoing labor induction with unfavorable cervical examination.
Methods. A randomized controlled trial was conducted on 90 pregnant women at term gestation with unfavorable cervix, admitted to the labor ward for induction of labor at Ain Shams University Maternity Hospital between October 2022 and June 2023. They were assessed using the Bishop score, with monitoring of differences between the two groups in terms of mode of delivery, time to enter active phase, time to delivery, changes in the Bishop score, and noted complications. This study was retrospectively registered on clinicaltrials.gov with identifier NCT06151925 in November 2023.
Results. In this study, the mode of delivery did not show a statistically significant difference between the two groups, with 66.7% having normal vaginal delivery (NVD) in the laminaria group compared to 71.1% in the prostaglandin group. Cesarean section (CS) was performed for 33.3% of the participants in the laminaria group and 28.9% in the prostaglandin group. The time required to enter the active phase (hrs.) was 16 (10 – 19) in the laminaria group and 12 (8 – 16) in the prostaglandin group, with this difference being statistically significant (p = 0.022). The induction delivery time (hrs.) also demonstrated a statistically significant difference between the two groups (P=0.036), with 20 (13 – 25) in the laminaria group and 16 (11 – 20) in the prostaglandin group.
Conclusions. Vaginal prostaglandin is more effective than Laminaria tents for cervical ripening before labor induction, leading to reduction in labor induction time and time to delivery.