title: Risk factors of surgical evacuation following second-trimester medical termination of pregnancy.
abstract: BACKGROUND
  Second-trimester medical termination of pregnancy (TOP) is associated with a higher risk of surgical evacuation than earlier medical TOP. Little is known about risk factors of surgical evacuation. Therefore, we assessed these risk factors among women undergoing second-trimester medical TOP.
  
  
  METHODS
  Data on 227 women were derived from a prospective randomized trial comparing 1- and 2-day mifepristone-misoprostol intervals in second-trimester medical TOP between 2008 and 2010.
  
  
  RESULTS
  The rate of surgical evacuation was 30.8%. The risk of surgical evacuation was increased by a history of curettage [odds ratio (OR) 4.4; 95% confidence interval (CI) 1.7-11.7], fetal indications for TOP (OR 6.1; 95% CI 1.1-34.4), age above 24 years (OR 2.4; 95% CI 1.1-5.3) and a 2-day interval (OR 2.2; 95% CI 1.1-4.1).
  
  
  CONCLUSIONS
  History of curettage, fetal indication, increasing age and 2-day interval between mifepristone and misoprostol increase the risk of surgical evacuation in cases of second-trimester medical TOP. These findings are important when optimizing clinical service in second-trimester TOP.
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland.
authors.forename: Maarit
authors.initials: M
authors.lastname: Mentula
authors.forename: Oskari
authors.initials: O
authors.lastname: Heikinheimo
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000021:Abortifacient Agents, Steroidal; D000025:Abortion, Eugenic / Q000009:adverse effects* / Q000379:methods; D000032:Abortion, Therapeutic / Q000009:adverse effects* / Q000379:methods; D000293:Adolescent; D000328:Adult; D004107:Dilatation and Curettage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008423:Maternal Age; D015735:Mifepristone; D016595:Misoprostol / Q000008:administration & dosage; D018457:Placenta, Retained / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone