title: Complications of surgical termination of second-trimester pregnancy in obese versus nonobese women.
abstract: BACKGROUND
  Obesity is becoming increasingly common in obstetric and gynecologic populations, which may affect the safety of surgical termination of pregnancy.
  
  
  METHODS
  We performed a retrospective review of all patients undergoing second-trimester surgical termination of pregnancy by under ultrasound guidance termination between 13 0/7 and 24 0/7 weeks of gestational age (GA) to compare perioperative risks in obese and nonobese women. Complication rates, operative times and anesthesia times were compared between obese [body mass index (BMI) ≥30 kg/m²] and nonobese women (BMI <30).
  
  
  RESULTS
  Of 1044 women, 29.0% were obese. The mean complication rate was 6.1% and similar between groups (5.5% nonobese, 7.6% obese, p=.20). Operative times were 4.4 min longer and mean anesthesia times were 5 min longer in obese patients (p<.001 for each). There was a nonsignificant trend toward more complications with gestational ages above 18 weeks (5.5% vs. 7.7%, p=.20). A history of one or more cesarean sections had an independent association with major complications after adjustment for confounders (adjusted odds ratio 4.2, p=.001).
  
  
  CONCLUSIONS
  Both anesthesia and operative times were modestly increased in obese women versus nonobese women undergoing second-trimester surgical termination, without significant differences in complication rates. For patients at advanced GA with prior cesarean delivery, clinicians should be aware of the potential increase in complications as well as increased operative time in obese women, and counsel appropriately.
authors.affiliation: University of Rochester Department of OB/GYN, Rochester, NY 14642, USA.
authors.forename: Lisbeth A
authors.initials: LA
authors.lastname: Murphy
authors.forename: Loralei L
authors.initials: LL
authors.lastname: Thornburg
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Glantz
authors.forename: Emilie C
authors.initials: EC
authors.lastname: Wasserman
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Stanwood
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Betstadt
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects*; D000293:Adolescent; D000328:Adult; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D015992:Body Mass Index; D002585:Cesarean Section / Q000009:adverse effects; D002648:Child; D005260:Female; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D009765:Obesity / Q000503:physiopathology*; D061646:Operative Time; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D012306:Risk; D055815:Young Adult