Hypersensitivity reactions following laminaria placement

Laminaria tents are commonly placed intracervically prior to elective termi nation of pregnancy. Three women, each of whom had undergone at least one p revious abortion in which a laminaria was utilized, developed hypersensitiv ity reactions following laminaria placement. The reactions included urticar ia, angioedema and respiratory distress. All responded to removal of the la minaria and administration of either diphenhydramine, prednisone, inhaled b ronchodilators or subcutaneous epinephrine. One of the women subsequently u nderwent skin testing and was positive to laminaria. patients undergoing la minaria placement may manifest a Type I reaction, IgE-mediated sensitivity. Providers should counsel patients with histories of multiple previous lami naria insertions about this possibility, have alternative methods of cervic al dilation available, and be able to promptly recognize and treat reaction s when they occur. (C) 2000 Elsevier Science Inc. All rights reserved.