Recent advances in second-trimester abortion: an evidence-based review

Area of Science:

• Medical and Surgical Abortion
• Reproductive Health Outcomes

Background:

• The proportion of second-trimester abortions in the US has remained consistent since 1992.
• Dilation and evacuation (D&E) has been the predominant method for second-trimester abortions, with extensive safety data supporting its use over three decades.

Purpose of the Study:

• To analyze the evolving safety and efficacy of second-trimester abortion methods.
• To highlight recent advancements in both surgical (D&E) and medical induction abortion regimens.

Main Methods:

• Review of 30 years of cumulative data on second-trimester abortion procedures in the United States.
• Analysis of trends in the utilization and safety profiles of D&E and induction abortion methods.

Main Results:

• The safety of dilation and evacuation (D&E) is well-established, with little variation in its proportion since 1992.
• Recent innovations in D&E and induction abortion regimens have narrowed the historical safety difference between medical and surgical approaches.
• New options allow for expedited D&E by shortening cervical ripening and reduced intervals for medical induction abortions.

Conclusions:

• Both D&E and medical induction abortion methods are evolving, enhancing patient care options.
• The narrowing safety gap provides clinicians with greater flexibility in managing second-trimester abortions.
• Continued advancements promise improved safety and efficiency in second-trimester abortion care.