title: Termination of multiple pregnancy at 18-24 weeks' gestation by Laminaria dilatation and evacuation.
abstract: OBJECTIVE
  To compare outcome in women undergoing termination of multiple pregnancy as compared with singleton pregnancy at 18-24 weeks' gestation by Laminaria dilatation and evacuation.
  
  
  METHODS
  The medical records of 372 consecutive women undergoing does not increase pregnancy termination by Laminaria dilatation and evacuation at 18-24 weeks' gestation between January 1997 and December 2001 were reviewed and divided into a group with multiple pregnancies (38 cases) and a group with singleton pregnancies (334 cases). The 2 groups were then compared for differences in patient characteristics, indications for pregnancy termination and operative outcome. Statistical methods included Student's t and chi2 test.
  
  
  RESULTS
  Patients with multiple pregnancies were significantly older (P < .01), and a greater percentage of them were married (P < .001). The percentage of pregnancies following infertility treatment was also significantly higher in the group with multiple pregnancies (P < .0001). Furthermore, significantly more patients with multiple than singleton pregnancy underwent pregnancy termination due to preterm premature rupture of membranes (42.1% vs. 0.3%) (P < .00001), while significantly more singleton pregnancies were terminated due to structural and chromosomal fetal malformations (34.5% vs 10.6%) (P = .03). Operative outcome between the study groups differed mainly regarding blood transfusion; it was significantly greater in the group of patients undergoing multiple, as compared with singleton, termination (7.9% vs. 0.3%) (P < .00001). The group with multiple pregnancy had a longer hospital stay (1.7 +/- 0.9 vs. 1.2 +/- 0.5 days) (P < .001).
  
  
  CONCLUSIONS
  Termination of multiple pregnancies at 18-24 weeks' by dilatation and evacuation appears safe when performed by skilled surgeons. There is an increased need for blood transfusion.
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Reuvit
authors.initials: R
authors.lastname: Halperin
authors.forename: Zvika
authors.initials: Z
authors.lastname: Vaknin
authors.forename: Ido
authors.initials: I
authors.lastname: Ben-Ami
authors.forename: Ian
authors.initials: I
authors.lastname: Bukovsky
authors.forename: David
authors.initials: D
authors.lastname: Schneider
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D001803:Blood Transfusion; D004106:Dilatation; D005260:Female; D006801:Humans; D007795:Laminaria; D008423:Maternal Age; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D016896:Treatment Outcome