title: Risk of hemorrhage during surgical evacuation for second-trimester intrauterine fetal demise.
abstract: To assess risk of hemorrhage during surgical evacuation for intrauterine fetal demise (IUFD).
  
  
  
  We compared hemorrhage associated with surgical evacuation for IUFDs ≥14weeks to surgical evacuations for other indications.
  
  
  
  From 12/2005 to 4/2013, 477 in-hospital surgical evacuations met inclusion criteria (123 IUFD, 354 comparators). The groups were demographically similar. Hemorrhage occurred in 7.3% of IUFDs and 4.2% of controls (p=.18). Fetal demise ≥4weeks was associated with hemorrhage (odds ratio 6.8, 95% confidence interval 2.25-20.2). IUFD cases ≥21weeks' gestational age (GA) had greater risk than did similarly aged controls (31.3% vs. 1.8%; p<.001). Abnormal coagulation studies were not associated with hemorrhage.
  
  
  
  Hemorrhage was more common in IUFD cases ≥4weeks' duration or ≥21weeks' GA.
authors.affiliation: Division of Family Planning, Department of Obstetrics and Gynecology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA. Electronic address: afont19@gmail.com.
authors.forename: Amber N
authors.initials: AN
authors.lastname: Fontenot Ferriss
authors.affiliation: Division of Family Planning, Department of Obstetrics and Gynecology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA.
authors.forename: Laurin
authors.initials: L
authors.lastname: Weisenthal
authors.affiliation: Division of Family Planning, Department of Obstetrics and Gynecology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA.
authors.forename: Jeanelle
authors.initials: J
authors.lastname: Sheeder
authors.affiliation: Division of Family Planning, Department of Obstetrics and Gynecology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA.
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Teal
authors.affiliation: Division of Family Planning, Department of Obstetrics and Gynecology, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA.
authors.forename: Kristina
authors.initials: K
authors.lastname: Tocce
mesh_terms: D000032:Abortion, Therapeutic; D016063:Blood Loss, Surgical; D003120:Colorado; D004107:Dilatation and Curettage / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006470:Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014505:Urban Population
keywords: Dilation and evacuation; Hemorrhage; Intrauterine fetal demise; Surgical evacuation