Aftercare instructions for the Lamarina Procedure

When the pregnancy is more advanced and the uterus is larger, then we utilize laminaria to dilate the cervix. We place laminaria in the cervix, usually the day before the procedure, and allow it to dilate the cervix overnight. Laminaria is a little stick of dried seaweed, about the size of a matchstick, which will swell to many times its original size when it is in a moist environment. Placing the laminaria involves visualizing the cervix with a speculum. The laminaria may then be slid gently into the cervix. Sometimes it is necessary to grasp the cervix first. When the laminaria is in the cervix, a sponge is then placed into the vagina to hold it in place. This whole procedure usually takes less than a minute, and is not very difficult for most women.

With the laminaria in place, the patient may go home, where she may carry on all normal activities including bathing or showering, exercise, and moving her bowels. She should not have intercourse. Most women either do not notice that the laminaria is in place, or they have cramping, which is usually mild, and for which they may take Tylenol or ibuprofen.

The following day, the woman returns to the office at which time the laminaria is removed, and the abortion can take place.

Advantages of laminaria With the cervix already dilated, the doctor does not need to dilate further with instruments in most cases. Thus, although the laminaria requires an extra visit, it actually reduces the time required for the abortion itself, and reduces the discomfort of the procedure as well. We also feel that laminaria placement reduces the chance of a serious but rare complication, perforation of the uterus (poking a hole in the wall of the uterus), which can occur when dilating with instruments.

Potential complications with laminaria are few. Theoretically, it could break into fragments, or be difficult to remove. If left in place for more than 24 hours, it could cause infection. If placed improperly, it could cause perforation of the uterus. These complications are all quite rare. However, if one has the laminaria in, it is essential to return to the office the next day to have it removed.

Occasionally a woman comes for an abortion, has the laminaria placed, and then changes her mind. In this case, the laminaria may be removed, and the pregnancy may continue. However, the risk of miscarriage and infection are higher because the cervix has been dilated.

Aftercare instructions for the Lamarina Procedure