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Update on second-trimester surgical abortion.

Kate A Shaw1, Klaira Lerma

  • 1Division of Family Planning Services and Research, Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Stanford, California, USA.

Current Opinion in Obstetrics & Gynecology
|September 30, 2016
PubMed
Summary
This summary is machine-generated.

Second-trimester abortion is safe, with complication rates below 1%. Cervical preparation using medications like misoprostol and mifepristone enhances safety for surgical abortions, especially dilation and evacuation procedures.

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Area of Science:

  • Medical Science
  • Gynecology
  • Surgical Procedures

Background:

  • Second-trimester abortions carry a low complication rate of 0.41%.
  • Effective cervical preparation is crucial for reducing risks in second-trimester surgical abortions, particularly dilation and evacuation (D&E).

Purpose of the Study:

  • To review current literature on surgical second-trimester abortion techniques.
  • To evaluate the efficacy of various cervical preparation methods for second-trimester abortion.

Main Methods:

  • Literature review of recent studies on second-trimester abortion.
  • Analysis of data from a large retrospective observational cohort study (54,911 abortions).
  • Examination of adjuncts to osmotic dilators for cervical preparation, including misoprostol and mifepristone.

Main Results:

  • Both misoprostol and mifepristone are effective for cervical preparation, alone or with osmotic dilators, in abortions after 16 weeks.
  • Misoprostol, while associated with more pain, is a cost-effective adjunct.
  • Mifepristone has fewer side-effects but may be less cost-effective.

Conclusions:

  • Second-trimester abortion is a safe procedure.
  • Medications like mifepristone and misoprostol improve the safety and efficacy of both medical and surgical second-trimester abortions.
  • Cervical preparation strategies should be individualized based on patient, provider, and setting, considering all evidence-based options.