[Morbidity of dilatation and evacuation in the second trimester: an analysis].
OBJECTIVE
To compare the rates of complications of dilatation and evacuation (D&E) in the second trimester of pregnancy.


METHODS
Retrospective analysis of early complications after D&E in the second trimester (group A: 1988-1994) in comparison with D&E in the first trimester (group B: 1997) and with the induction of abortion by extra-amniotic application of prostaglandins in the second trimester of pregnancy (literature).


RESULTS
The overall complication rate of D&E was statistically significantly higher in the second than in the first trimester (p < 0.0001). The most frequent complication in both groups was a blood loss > 500 ml (p < 0.009). As with blood loss, there was a statistically significant increase in the incidence of postoperative bleeding (p < 0.001) and fever > 38 degrees C (p = 0.042) with rising gestational age, too. We registered similar rates for incomplete abortion, infection, cervical injury, uterine perforation and thrombosis.


CONCLUSIONS
Second-trimester pregnancy termination with D&E is associated with higher morbidity rates than in the first trimester. Overall, the rates of complications of D&E in our study were acceptable and comparable with the results of previous studies. Compared with the induction of abortion by extra-amniotic prostaglandins, D&E shows lower morbidity rates. In particular, the advantages of D&E are in the early second trimester.
Pauli
E
E
Departement Frauenheilkunde, Universitätsspital Zürich, Zürich, Schweiz. eliane.pauli@usz.ch
Haller
U
U
Zimmermann
R
R
D000028:Abortion, Induced / Q000009:adverse effects* / Q000706:statistics & numerical data; D000328:Adult; D016063:Blood Loss, Surgical; D004107:Dilatation and Curettage / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors