Two patients at 22 weeks' gestation underwent extensive cervical dilation with laminaria tents for elective abortion but continued their pregnancies instead. Both had normal deliveries. For the unusual patient who chooses not to carry out an abortion initiated with cervical dilation, successful pregnancy is possible and therapeutic intervention such as cervical cerclage seems inadvisable.
PIP: 2 patients at 22 weeks' gestation underwent extensive cervical dilation with laminaria tents for elective abortion but continued their pregnancies instead. Case 1 was 23 years old, gravida, 4, para, 1, elective abortions 2. She was a heroin addict. 12 laminaria tents were inserted over 2 days, and were apparently expelled on the 3rd day, with no effect on the pregnancy. After 37 weeks' gestation without prenatal care, she gave birth to a healthy 2790g female with Apgar scores of 8 and 8, and with no labor or postpartum complications. Case 2 was 27 years old, gravida 6, para 3, spontaneous abortions 2. She desired termination because of her home situation, and had 17 small tents placed over 2 days, but on the day of the scheduled abortion, she changed her mind. The tents were removed, and she was given oral erythromycin. At 40 weeks' gestation, she was spontaneously delivered of a 3080g male with Apgar scores 9 and 9. In both patients, the cervical dilation of 2-3cm, normally worrisome at this gestation, returned to normal within 1 week. For the unusual patient who chooses not to carry out an abortion initiated with cervical dilation, successful pregnancy is possible. Therapeutic intervention such as cervical cerclage seems inadvisable. Antibiotic treatment and referral for prenatal care seems the best course, and patients should be warned about the possibility of amniotitis and premature labor.