title: Safety of late second-trimester pregnancy termination by laminaria dilatation and evacuation in patients with previous multiple cesarean sections.
abstract: OBJECTIVE
  To assess whether there is an increased perioperative risk in termination of late second-trimester pregnancy after multiple cesarean sections by laminaria dilatation and evacuation.
  
  
  METHODS
  During the period between January 2002 and June 2008, 636 consecutive patients underwent late second-trimester (17-24 weeks) pregnancy terminations by dilatation and evacuation. Patients were divided into 3 subgroups: those with no previous cesarean section (n = 545), those with 1 previous cesarean section (n = 59), and those with several previous cesarean sections (n = 32).
  
  
  RESULTS
  There were no significant differences in major perioperative complications, such as anesthetic complications, need for blood transfusion, and cervical lacerations comparing the 3 subgroups. Importantly, there were neither cases of uterine perforation nor retained products of conception in the 3 subgroups.
  
  
  CONCLUSIONS
  Late second-trimester pregnancy termination after multiple cesarean sections by laminaria dilatation and evacuation is probably not associated with an increased perioperative risk. Larger studies are needed to empower this study.
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Ido
authors.initials: I
authors.lastname: Ben-Ami
authors.forename: David
authors.initials: D
authors.lastname: Schneider
authors.forename: Ran
authors.initials: R
authors.lastname: Svirsky
authors.forename: Noam
authors.initials: N
authors.lastname: Smorgick
authors.forename: Moty
authors.initials: M
authors.lastname: Pansky
authors.forename: Reuvit
authors.initials: R
authors.lastname: Halperin
mesh_terms: D000028:Abortion, Induced / Q000379:methods* / Q000706:statistics & numerical data; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D002921:Cicatrix; D004107:Dilatation and Curettage / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D010298:Parity; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D012449:Safety; D014595:Uterine Perforation / Q000453:epidemiology / Q000517:prevention & control*; D014599:Uterus / Q000473:pathology / Q000601:surgery