II. Indications
- Cervical dilation prior to Dilation and Curettage
III. Advantages
- Safe and effective
- Less cervical Trauma and pain than with dilator
IV. Preparations
- Laminaria digitata
- Seaweed stem of 2-3 mm width
- String attached to end for removal
- Swells on contact with water
- May reach up to 5x its original width in 12 hours
- Synthetic alternatives to Laminaria
- Dilateria
- Lamicel
- Dilapan
V. Procedure
- Prepare Cervix
- Insert uterine sound just past cervical os
- Opens cervical os to allow for insertion of Laminaria
- Helps determine cervical orientation
- Do not fully insert
- Not necessary to determine uterine depth
- Insert Laminaria
- Hold tenaculum to steady Cervix
- Hold Laminaria with ring forceps and insert into os
- Allow Laminaria tip to pivot to find cervical canal
- Fully insert Laminaria into Cervix
- Consider placing second Laminaria next to first
- Indicated if Gestational age >11 weeks
- Remove tenaculum
- Apply sponge against Laminaria to prevent removal
VI. Follow-up
- Leave Laminaria in overnight
- Remove Laminaria at time of Dilation and Curettage