Document Detail


Dilation and evacuation at >or=20 weeks: comparison of operative techniques.
MedLine Citation:
PMID:  15167815     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study is to compare the relative safety of 2 techniques for surgical abortion late in the second trimester.Study design Retrospective review of patients who underwent surgical abortion at >or=20 weeks' gestation at our hospital from June 1996 through June 2003. Records were reviewed to determine whether the technique used was dilation and evacuation or intact dilation and extraction. Subsequent pregnancies at our hospital were identified, and obstetric outcomes were recorded. Categorical data were compared with Fisher exact test and chi(2) analysis. Continuous data were compared with Mann-Whitney U test. RESULTS: Three hundred eighty-three patients met inclusion criteria. Intact dilation and extraction was performed in 120 cases, and dilation and evacuation was used in 263. Intact dilation and extraction was associated with higher parity, later gestational age, and more preoperative cervical dilation. There was no difference in procedure time or estimated blood loss in the 2 groups. Complications occurred in 19 cases (5.0%), and occurred with similar frequency in the 2 groups. We identified 62 subsequent pregnancies. There were no second-trimester miscarriages. Spontaneous preterm birth occurred in 2 of 17 (11.8%) pregnancies in the intact dilation and extraction group, compared with 2 of 45 (4.4%) in the dilation and evacuation group (P=.30). CONCLUSION: Outcomes appear similar between patients undergoing dilation and evacuation and intact dilation and extraction after 20 weeks' gestation. Subsequent obstetric outcomes are similar between the 2 groups. The technique for surgical abortion should be determined by the physician on the basis of intraoperative factors.
Authors:
Stephen T Chasen; Robin B Kalish; Meruka Gupta; Jane E Kaufman; William K Rashbaum; Frank A Chervenak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  190     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-28     Completed Date:  2004-07-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1180-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA. stchasen@med.cornell.edu
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MeSH Terms
Descriptor/Qualifier:
Abortion, Induced / adverse effects,  methods*
Adolescent
Adult
Dilatation and Curettage / adverse effects,  methods*
Female
Follow-Up Studies
Gestational Age
Humans
Middle Aged
Postoperative Complications
Pregnancy
Pregnancy Outcome*
Pregnancy Trimester, Second
Probability
Retrospective Studies
Risk Assessment
Statistics, Nonparametric
Vacuum Extraction, Obstetrical / adverse effects,  methods*
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2004 May;190(5):1175-6   [PMID:  15167812 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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