This study compares the effectiveness of cervical preparation before second trimester abortion using laminaria versus vaginal Misoprostol.

The investigators hypothesize that medical preparation of the cervix with vaginal Misoprostol is superior to mechanical preparation using laminaria.

The investigators believe that medical preparation makes the procedure easier to perform, equally safe, without addition of pain or discomfort.

This is a prospective randomized study.

The aim of the study is to compare preparation of the cervix before surgical abortion with laminaria and misoprostol.

Primary outcome measures will include:

Initial cervical opening and the need for further dilatation at the procedure Procedure duration

Difficulty score performing the abortion

Complications during and after the procedure

Assessment of pain, using VAS scale, and the need for analgesia before and after the procedure

Inclusion Criteria:

• Pregnant patients with a viable singleton
• Pregnancy 14-20 weeks of gestation
• Admitted for termination of pregnancy

Exclusion Criteria:

• Contraindication for administration of Misoprostol
• Patients with more than one previous cesarean section scar
• Patients with impaired coagulation
• Significant pulmonary or cardiac disease
• Non viable pregnancy
• Placenta accreta or previa by ultrasound