Document Detail

Impact of midtrimester dilation and evacuation on subsequent pregnancy outcome.
MedLine Citation:
PMID:  12388969     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study was undertaken to evaluate the impact of second-trimester dilation and evacuation (D&E) on subsequent pregnancy outcome. STUDY DESIGN: Medical record review of 600 patients undergoing midtrimester (14-24 weeks) D&E from 1996 to 2000 and evaluation of subsequent pregnancy outcome. Mann Whitney U, Spearman rho, and chi(2) tests were used in statistical analysis with a P value <.05 considered significant. RESULTS: Ninety-six subsequent pregnancies were identified, including 12 first-trimester spontaneous abortions, 1 second-trimester fetal death, 1 ectopic pregnancy, and 5 elective terminations. Seventy-seven pregnancies resulted in the delivery of a live-born infant at a median gestational age of 39.0 weeks. Five pregnancies (6.5%) were complicated by spontaneous preterm birth. Patients delivered preterm had an earlier gestational age at D&E (18.0 vs 20.0 weeks, P =.02) and a trend toward less preoperative cervical dilation (2.0 vs 3.0 cm, P =.09) than patients delivered at term. CONCLUSION: Second-trimester D&E is not a risk factor for midtrimester pregnancy loss or spontaneous preterm birth. Preterm delivery in future gestations appears less likely when greater preoperative cervical dilation is achieved with laminaria, possibly because of a decrease in cervical trauma.
Robin B Kalish; Stephen T Chasen; Laura B Rosenzweig; 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:  187     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-21     Completed Date:  2002-11-19     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  882-5     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New York Weill Cornell Medical Center, 525 E. 68th Street, Room J-130, New York, NY 10021, USA.
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MeSH Terms
Abortion, Induced / methods*
Dilatation and Curettage* / adverse effects
Follow-Up Studies
Gestational Age
Labor Stage, First
Medical Records
Obstetric Labor, Premature / etiology
Obstetrical Forceps
Pregnancy Outcome*
Pregnancy Trimester, Second
Retrospective Studies
Risk Factors
Comment In:
Am J Obstet Gynecol. 2003 Aug;189(2):613-4; author reply 614   [PMID:  14524363 ]

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

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