title: Coagulopathy associated with dilation and evacuation for second-trimester abortion.
abstract: OBJECTIVE
  To characterize the clinical and laboratory features of coagulopathy following second-trimester surgical abortions. DESIGN. Retrospective study.
  
  
  METHODS
  Gynecologic unit of a university-affiliated medical center.
  
  
  METHODS
  1249 consecutive women underwent late second-trimester (16-24 weeks) surgical abortions between January 2002 and June 2010. Of those, 20 women (1.6%) were diagnosed with excessive bleeding accompanied by coagulopathy.
  
  
  METHODS
  Women were divided into two groups based on whether the abortion was performed for fetal demise (n=14) or pregnancy termination (n=6).
  
  
  METHODS
  Gestational age, indication for abortion, blood clotting tests, number of blood products and coagulation factors administered.
  
  
  RESULTS
  Women who had pregnancy termination began to bleed significantly earlier than those with fetal demise (p<0.05). A significantly higher number of women with fetal demise had a gradual deterioration of the clotting test, compared with women who had pregnancy termination (p<0.05). In women with fetal demise, early bleeding was associated with a more severe clinical presentation.
  
  
  CONCLUSIONS
  Coagulopathy following surgical abortion manifests differentially in women who have fetal demise and those who have pregnancy termination, implying a different pathophysiology. Women with fetal demise suffering from excessive bleeding following surgical abortion accompanied with mild clotting test abnormalities should be carefully monitored to diagnose and treat an impending disseminated intravascular coagulation.
authors: Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Ido
authors: I
authors: Ben-Ami
authors: Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Noga Fuchs
authors: https://orcid.org/0000-0002-5128-0941
authors: NF
authors: Weizman
authors: Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: David
authors: D
authors: Schneider
authors: Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Moty
authors: M
authors: Pansky
authors: Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Reuvit
authors: R
authors: Halperin
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects* / Q000379:methods; D000328:Adult; D001778:Blood Coagulation Disorders / Q000175:diagnosis; D004107:Dilatation and Curettage; D005260:Female; D005313:Fetal Death / Q000601:surgery; D006801:Humans; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies