Mid-trimester abortion by dilatation and evacuation: a safe and practical alternative

Area of Science:

• Reproductive Health
• Medical Procedures
• Obstetrics & Gynecology

Background:

• Mid-trimester abortions are often considered hazardous and impractical.
• Dilatation and evacuation (D&E) and intra-amniotic saline instillation are common methods.

Purpose of the Study:

• To compare the safety and feasibility of D&E versus saline-induced abortions between the 13th and 20th weeks of pregnancy.

Main Methods:

• A comparative study of 6,213 D&E abortions and 8,662 saline-induced abortions.
• Data collected on major complications, need for further treatment, and method failure rates.

Main Results:

• D&E abortions showed significantly lower rates of major complications (0.69% vs. 1.78%).
• D&E had reduced rates for antibiotic administration (2.22% vs. 5.65%), blood transfusion (0.19% vs. 0.91%), and repeat uterine evacuation (0.98% vs. 34.10%).
• Method failure was also lower with D&E (0.11% vs. 2.52%).

Conclusions:

• D&E appears to be a safe and practical method for mid-trimester abortions up to 20 weeks.
• Further randomized trials are needed to fully establish the role of D&E in mid-trimester abortion care.