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Second trimester termination of pregnancy: a review by site and procedure type
David K Turok1, Shawn E Gurtcheff, Michael S Esplin
1Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, UT 84132-2209, USA. david.turok@hsc.utah.edu
Background:
We hypothesized that complications for second trimester terminations are higher in a low-volume residency training program than in a high-volume private practice.
Study Design:
Complications and cost were compared between three groups undergoing second trimester terminations: patients undergoing dilation and evacuation (D&E) at a university hospital (Hospital D&E, n=83) or medical pregnancy termination at a university hospital (Hospital Induction, n=89) and D&E at a private outpatient facility (Clinic D&E, n=253).
Results:
Major complications occurred in 11% of the Hospital D&E, 10% of the Hospital Induction, and 1% of the Clinic D&E patients (p=.0019). Complication rates remained statistically significant when a logistic regression model was applied to the data. The mean total charge for the three respective groups was US$4625, US$5029 and US$1105 (p<.001).
Conclusion:
Second trimester terminations of pregnancy by D&E in well-selected patients in a dedicated outpatient facility can be safer and less expensive than hospital-based D&E or induction of labor.
