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Methods of midtrimester abortion: which is safest?
Summary
Dilatation and Evacuation (D&E) is the safest abortion method for patients 13+ weeks gestation. Saline instillation is safer than prostaglandin F2alpha (PGF2alpha), which significantly increased serious morbidity.
Area of Science:
- Medical research
- Reproductive health
- Surgical procedures
Background:
- Three primary abortion methods exist for gestations of 13 or more weeks: intraamniotic saline, prostaglandin F2alpha (PGF2alpha), and dilatation and evacuation (D&E).
- The comparative safety of these midtrimester abortion procedures had not been previously established.
Purpose of the Study:
- To compare the safety and efficacy of saline instillation, PGF2alpha, and D&E for midtrimester abortions.
Main Methods:
- Analysis of data from 17,467 abortions collected by the Joint Program for the Study of Abortion (JPSA) under the CDC.
- Statistical comparison of complication rates between saline instillation, PGF2alpha, and D&E procedures.
Main Results:
- D&E was significantly safer than saline instillation (p < 0.001).
- Saline instillation was significantly safer than PGF2alpha (p < 0.01).
- PGF2alpha significantly increased serious morbidity, despite accelerating abortion time.
Conclusions:
- Midtrimester D&E is a safe and practical outpatient procedure.
- D&E is the safest method among the three studied for midtrimester abortions.
- PGF2alpha is associated with higher risks of serious morbidity compared to saline and D&E.