A comparison of medical induction and dilation and evacuation for second-trimester abortion.
OBJECTIVE
The purpose of this study was to compare complication rates of patients who undergo dilation and evacuation or medical abortion between 14 and 24 weeks of gestation.


METHODS
We present a retrospective cohort study of 297 women who underwent either dilation and evacuation or medical abortion. Statistical methods included the Student t test, the chi(2) test, the Fisher exact test (where appropriate), and logistic regression.


RESULTS
The overall complication rate was significantly lower in patients who underwent dilation and evacuation than in patients who underwent medical abortion (4% vs 29%; P <.001). Medical abortions with misoprostol resulted in a lower complication rate than abortions with other medications (odds ratio, 0.2; 95% CI, 0.1-0.4). More Laminaria was associated with a decreased risk of complications with surgical abortions (odds ratio, 0.9; 95% CI, 0.7-1.0).


CONCLUSIONS
Dilation evacuation is the safest method of second-trimester abortion. Misoprostol is safer than other methods for medical abortion. Maximal use of Laminaria will decrease complication rates in surgical abortion.
Medical College of Wisconsin, Milwaukee, USA.
Amy M
AM
Autry
Ellen C
EC
Hayes
Gavin F
GF
Jacobson
Russell S
RS
Kirby
D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects* / Q000592:standards; D000028:Abortion, Induced / Q000009:adverse effects* / Q000379:methods / Q000592:standards; D000328:Adult; D015331:Cohort Studies; D004107:Dilatation and Curettage / Q000009:adverse effects* / Q000592:standards; D005260:Female; D006801:Humans; D016015:Logistic Models; D016595:Misoprostol / Q000009:adverse effects* / Q000592:standards; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol