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Related Experiment Video

Updated: Mar 31, 2026

Modeling Ascending Vaginal Infection, Preterm Birth, and Neonatal Morbidity in Mice
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Second trimester dilation and evacuation: a risk factor for preterm birth?

S E Little1, E Janiak2, D Bartz2

  • 1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
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Second trimester pregnancy termination using dilation and evacuation (D&E) does not increase the risk of subsequent preterm birth compared to induction of labor (IOL). This finding was consistent when compared to national averages and across varying numbers of prior procedures.

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Health
  • Maternal-Fetal Medicine

Background:

  • Second trimester pregnancy termination is performed for various medical reasons.
  • Understanding the long-term reproductive outcomes, specifically preterm birth risk, following different termination methods is crucial for patient counseling.

Purpose of the Study:

  • To compare the subsequent risk of preterm birth in women who underwent second trimester pregnancy termination via dilation and evacuation (D&E) versus induction of labor (IOL).

Main Methods:

  • Retrospective cohort study of 173 women undergoing second trimester termination for fetal anomalies, fetal death, or previable premature rupture of membranes.
  • Analysis of spontaneous delivery rates before 37 weeks in the first pregnancy post-termination.
  • Comparison of cohort preterm birth rates with national averages and analysis by the number of prior procedures.

Main Results:

  • Women undergoing D&E (n=130) had a significantly lower rate of subsequent preterm birth (6.9%) compared to those undergoing IOL (30.2%; P<0.01).
  • This association persisted in a subset of women without obstetric risk factors.
  • No statistical difference in preterm birth rates was observed between D&E and national averages, or across varying numbers of prior first or second trimester procedures.

Conclusions:

  • Dilation and evacuation (D&E) for second trimester pregnancy termination was not found to be a risk factor for subsequent preterm delivery when compared to induction of labor (IOL) or national rates.
  • The findings suggest D&E is a safe procedure regarding future pregnancy outcomes related to preterm birth.