Second-Trimester Pregnancy Termination by Dilation and Evacuation After Detection of Fetal Abnormalities

Abstract

Dilation and evacuation (D and E) is the most common procedure used for second-trimester pregnancy termination in the United States. However, most second-trimester pregnancy terminations performed after detection of fetal abnormalities are accomplished by labor induction techniques, usually initiated by intravaginal prostaglandin suppositories. D and E has been shown to be superior to labor induction methods with respect to morbidity, mortality, psychologic impact, and economics when performed in the second trimester. We have performed 192 D and E procedures during the second trimester (14–22 weeks gestation) for women electing to terminate their pregnancies after detection of fetal abnormalities. One intraoperative and three postoperative complications occurred. In all but one case, prenatal diagnosis was confirmed by pathologic, cytogenetic, or DNA studies of the products of conception. We conclude that D and E performed by experienced obstetrician-gynecologists is reliable for confirming most prenatal diagnoses and should be offered to women who elect to terminate pregnancies in the second trimester because of fetal abnormalities.