Obstetric outcomes after surgical abortion at > or = 20 weeks' gestation.
OBJECTIVE
The purpose of this study was to describe obstetric outcomes after surgical abortion at > or = 20 weeks, and to identify risk factors for subsequent spontaneous preterm birth.


METHODS
Patients who had surgical abortion at > or = 20 weeks' gestation from 1996 to 2003 and received subsequent prenatal care at The New York Weill Cornell Medical Center were identified. Indication for abortion, operative technique, and subsequent pregnancy outcomes were reviewed. Student t test, Fisher exact test, and Mann-Whitney U were used where appropriate.


RESULTS
One hundred and twenty pregnancies in 89 women were identified. Thirteen (10.8%) ended with early miscarriage, and 5 were electively terminated. Of the remaining 102 pregnancies, 7 ended with spontaneous preterm birth. Those who experienced preterm birth were more likely to have undergone abortion due to cervical dilation and/or preterm premature rupture of membranes (PPROM) (27.3% vs 4.4%; P = .03). Those with a multifetal pregnancy in the subsequent pregnancy were more likely to have preterm birth (75.0% vs 4.3%; P < .001). In patients who underwent dilation and evacuation (D&E) for reasons other than cervical dilation and/or PPROM, rates of spontaneous preterm birth were identical between those who had intact dilation and extraction (D&X) and D&E using forceps (4.2% vs 4.5%; P = 1.0).


CONCLUSIONS
In those who have undergone D&E at > or = 20 weeks, only a history of midtrimester cervical dilation and/or PPROM or a current multifetal pregnancy were associated with spontaneous preterm birth.
Chasen
Stephen T
ST
Division of Maternal-Fetal Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA. stchasen@med.cornell.edu
Kalish
Robin B
RB
Gupta
Meruka
M
Kaufman
Jane
J
Chervenak
Frank A
FA
D000028:Abortion, Induced; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000601:surgery; D005865:Gestational Age; D013509:Gynecologic Surgical Procedures; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000453:epidemiology*; D012307:Risk Factors