Using Prophylactic Antihemorrhagic Medications in Second-Trimester Surgical Abortions.

Area of Science:

• Medical Science
• Obstetrics & Gynecology
• Surgical Safety

Background:

• Hemorrhage and estimated blood loss (EBL) are potential complications during dilation and evacuation (D&E).
• Prophylactic antihemorrhagic medications aim to mitigate these risks.
• Understanding the efficacy of these medications is crucial for patient safety.

Purpose of the Study:

• To evaluate the association between prophylactic antihemorrhagic medication use and operative hemorrhage during D&E.
• To assess the impact of these medications on estimated blood loss (EBL) in D&E procedures.

Main Methods:

• Retrospective review of records for patients undergoing D&E between 14 and <22 weeks of gestation (January 2012 - December 2019).
• Defined prophylactic antihemorrhagic medication use as administration of vasoconstrictors, uterotonics, or both prior to hemorrhage identification.
• Compared rates of operative hemorrhage and EBL between patients who received prophylactic medications and those who did not.

Main Results:

• Prophylactic medications were administered in 72.1% of 147 D&E procedures.
• Prophylactic medication use was significantly associated with lower rates of operative hemorrhage (21.7% vs 51.2%, P <.01).
• Patients receiving prophylactic medications experienced significantly lower EBL (336.9 mL vs 551.3 mL, P <.01).

Conclusions:

• Prophylactic antihemorrhagic medication use is associated with a significant reduction in operative hemorrhage during D&E.
• These medications are linked to decreased estimated blood loss in patients undergoing D&E procedures.
• The findings support the routine use of prophylactic antihemorrhagic medications to improve safety in D&E procedures.