Obesity and second-trimester abortion by dilation and evacuation.
OBJECTIVE
To examine the relationship between body mass index (BMI) and dilation and evacuation (D&E) procedure characteristics.


METHODS
Data were collected on all women seeking elective surgical second-trimester abortion during a six-week period at a free-standing abortion clinic. Information gathered included age, pregnancy history, height, weight, intravenous sedation, time for procedure, estimated blood loss, use of special instruments, amount of manual dilation needed and gestational age by ultrasound and pathology. Difficulty was rated by a single physician immediately following the surgery using a 10-cm line later converted to a visual analog score.


RESULTS
One hundred ninety-eight women underwent D&E during the study period. Data were complete for 163 (82%). Subject demographics and procedure outcomes were analyzed with BMI as a variable. A trend was observed for increased procedure difficulty, time for procedure, blood loss and complications as BMI increased. On average, the procedure for a subject with BMI > or = 30 took 20% longer and was rated as 40% more difficult to perform as compared to procedures on women with BMI < 30.


CONCLUSIONS
We identified a trend with BMI score and some D&E procedure characteristics, but the power of the study was limited. Abortion providers should be aware that obesity may necessitate the availability of special instruments and/or an alterations in surgical technique.
Dark
Allison C
AC
Feminist Women's Health Center, Renton, Washington, USA.
Miller
Leslie
L
Kothenbeutel
Robert L
RL
Mandel
Lynn
L
D000028:Abortion, Induced / Q000295:instrumentation* / Q000379:methods*; D000328:Adult; D015992:Body Mass Index; D004106:Dilatation / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D016896:Treatment Outcome