Serial multiple laminaria and adjunctive urea in late outpatient dilatation and evacuation abortion

The safety and clinical approach in late second-trimester outpatient dilatation and evacuation abortion is controversial. In this series, 1000 dilatation and evacuation abortions were performed on patients from 17 through 25 menstrual weeks' gestation in a private office outpatient facility. Each patient experienced serial multiple laminaria treatment over two days before abortion. Patients at 20 weeks' gestation or more also received adjunctive urea amnioinfusion on the day of the procedure. Three patients (0.3%) experienced major complications. Although a wide variety of clinical problems was encountered, procedure times were short, blood loss was generally low, and other complication rates were low. Recommendations for staffing and the prevention of complications are discussed.