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Updated: Aug 18, 2026
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
[Morbidity of dilatation and evacuation in the second trimester: an analysis]
E Pauli1, U Haller, R Zimmermann
1Departement Frauenheilkunde, Universitätsspital Zürich, Zürich, Schweiz. eliane.pauli@usz.ch
Objective:
To compare the rates of complications of dilatation and evacuation (D&E) in the second trimester of pregnancy.
Study Design:
Retrospective analysis of early complications after D&E in the second trimester (group A: 1988-1994) in comparison with D&E in the first trimester (group B: 1997) and with the induction of abortion by extra-amniotic application of prostaglandins in the second trimester of pregnancy (literature).
Results:
The overall complication rate of D&E was statistically significantly higher in the second than in the first trimester (p < 0.0001). The most frequent complication in both groups was a blood loss > 500 ml (p < 0.009). As with blood loss, there was a statistically significant increase in the incidence of postoperative bleeding (p < 0.001) and fever > 38 degrees C (p = 0.042) with rising gestational age, too. We registered similar rates for incomplete abortion, infection, cervical injury, uterine perforation and thrombosis.
Conclusion:
Second-trimester pregnancy termination with D&E is associated with higher morbidity rates than in the first trimester. Overall, the rates of complications of D&E in our study were acceptable and comparable with the results of previous studies. Compared with the induction of abortion by extra-amniotic prostaglandins, D&E shows lower morbidity rates. In particular, the advantages of D&E are in the early second trimester.
