Document Detail


Intraoperative blood loss and gestational age at pregnancy termination.
MedLine Citation:
PMID:  10838389     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: To establish the relationship of measured intraoperative blood loss to gestational age at pregnancy termination, and to determine which factors, if any, affect the risk of bleeding.Methods: A single-operator series of 363 consecutive women undergoing pregnancy termination between 5 and 24 weeks gestational age, as dated by ultrasound, was prospectively evaluated. All pregnancies under 13 weeks gestation were terminated by mechanical dilation and suction curettage without preoperative cervical ripening. All pregnancies between 13 and 24 weeks gestation were terminated by preoperative osmotic cervical dilation with laminaria tents and subsequent uterine evacuation by a combination of suction curettage, sharp curettage, and Bierer forceps extraction. All patients over 12 weeks gestation received a postoperative oxytocin infusion. Whenever possible, amniotic fluid and blood were collected and measured separately. Patients were excluded from the data analysis for pregnancy demise, PPROM, Potter's syndrome, or inability to separate blood establish their relationship. After adjustment for gestational age, the results were analyzed to determine if blood loss was related to maternal age, smoking history, body habitus, or operative indication.Results: A curvilinear relationship between blood loss and gestational age was observed. Mean blood loss at 24 weeks exceeded 800 mL. After adjustment for gestational age, no factors significantly affected blood loss at dilation and aspiration of first trimester pregnancies. In those patients undergoing dilation and evacuation in the second trimester, both simple and stepwise regression analyses showed obesity (BMI >/=32.3) to be significantly associated with increased blood loss (P <.05). Neither age, parity, previous cesarean section, nor smoking history were significantly associated with increased blood loss at dilation and evacuation.Conclusions: With advancing gestational age, intraoperative blood loss increases in curvilinear fashion. Termination providers should be advised that, although blood loss is unaffected by many factors, obese patients are at risk for increased bleeding at dilation and evacuation of pregnancies beyond 12 weeks gestation.
Authors:
Marchiano; Thomas; Lapinski; Balwan; Patel
Related Documents :
8717569 - Terminations of pregnancy for exposure to oral retinoids in south australia, 1985-1993.
2342729 - Dilation and evacuation for second-trimester genetic pregnancy termination.
15512679 - Induced abortion: a four-year experience at a university gynaecological clinic in greece.
17131609 - Exploration of the views of traditional healers regarding the termination of pregnancy ...
19747679 - Comparison of four perioperative misoprostol regimens for surgical termination of first...
3947029 - Constitutional hypofibrinogenemia associated with third trimester hemorrhage.
20492379 - Difference of fetal heart rate accelerations based on 10 and 15 beats per minute.
11821299 - Serum free beta-hcg and alpha-fetoprotein levels in ivf, icsi and frozen embryo transfe...
9788649 - Blunted fetal response to vibroacoustic stimulation following chronic exposure to propr...
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Primary care update for Ob/Gyns     Volume:  5     ISSN:  -     ISO Abbreviation:  Prim. Care Update Ob Gyns     Publication Date:  1998 Jul 
Date Detail:
Created Date:  2000-06-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431228     Medline TA:  Prim Care Update Ob Gyns     Country:  -    
Other Details:
Languages:  ENG     Pagination:  204-205     Citation Subset:  -    
Affiliation:
Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai Medical Center, New York, New York, USA
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Prediction of endometrial ablation success by preoperative findings.
Next Document:  Clinical outcomes of OPERA, out-patient endometrial resection/ablation.