Uterine curettage following second trimester abortion by extraovular instillation of prostaglandin E2. A prospective-randomized trial.
OBJECTIVE
To evaluate the benefits associated with routine uterine curettage following complete second trimester termination of pregnancy by extraovular prostaglandin E2.


METHODS
Fifty-five patients between 15 and 24 weeks' gestation who had undergone complete termination of pregnancy by continuous extraovular instillation of prostaglandin E2 (PGE2), were randomly assigned into either no further intervention (n=25), or uterine curettage under general anesthesia (n=30). The need for late uterine curettage, clinical and ultrasonographic parameters at 1 and 42 days follow-up, as well as the incidence of the minor and major complications, were compared between groups.


RESULTS
Baseline and post-abortion clinical and ultrasonographic characteristics were similar in both groups. Mean (+/- Standard error of the mean) number of post-abortion bleeding days in the curettage group was 8.9+/-1.8 versus 10.1+/-2.6 days in the non-curettage group (P=NS). No patient in the former group, compared to three patients in the latter group, needed late uterine curettage, (P=NS). Major and minor complications rates in the curettage and in the no-curettage groups were not significantly different. Considerably more patients in the curettage group needed analgesic agents following the abortion compared to the no-curettage group (60% vs. 3.3%, respectively; P<0.001).


CONCLUSIONS
Routine uterine curettage in patients undergoing complete second trimester termination of pregnancy by extraovular instillation of PGE2, exerts no benefit.
Atad
J
J
Department of Obstetrics and Gynecology, Carmel Medical Center, The Technion School of Medicine, Haifa, Israel. atad_dev@netvision.net.il
Hallak
M
M
Fruchter
O
O
Yshai
D
D
Auslender
R
R
Abramovici
H
H
D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D000698:Analgesia; D004107:Dilatation and Curettage; D015232:Dinoprostone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies
D015232:Dinoprostone