title: Obesity and second-trimester abortion by dilation and evacuation.
abstract: 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.
authors.affiliation: Feminist Women's Health Center, Renton, Washington, USA.
authors.forename: Allison C
authors.initials: AC
authors.lastname: Dark
authors.forename: Leslie
authors.initials: L
authors.lastname: Miller
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kothenbeutel
authors.forename: Lynn
authors.initials: L
authors.lastname: Mandel
mesh_terms: 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