Transactions of The Twenty-Second Annual Meeting of The Society for Maternal-Fetal MedicineImpact of midtrimester dilation and evacuation on subsequent pregnancy outcome☆
Section snippets
Material and methods
Retrospective review of the medical charts of all patients who underwent D&E at 14 to 24 weeks at New York Weill Cornell Medical Center was performed by a single physician (W. K. R.) from May 1996 to May 2000. Institutional review board (IRB) approval was obtained for this study. All patients were referred to our center for termination of pregnancy. Gestational age was confirmed by ultrasound in all cases.
Patients were seen in an outpatient setting for initial evaluation. Cervical dilation was
Results
From 600 second-trimester D&E procedures performed during the study period, 96 subsequent pregnancies were identified in 81 women. The median gestational age (GA) at D&E was 19.0 weeks (range 14-24 weeks). The median maternal age at D&E was 33 years (range 19-44 years). At the time of D&E, 64.6% of women were nulliparous. The median interval from D&E to subsequent delivery was 1.35 years (range 0.76-5.03). Indication for the procedure included: aneuploidy (31), structural anomaly (19), fetal
Comment
The current study demonstrates that, in experienced hands, second-trimester D&E is not associated with a high incidence of second-trimester pregnancy loss or preterm birth in subsequent gestations. In our series, there were no second-trimester spontaneous abortions and only 6.5% spontaneous preterm deliveries. Our findings are consistent with those of Schneider et al,12 who reviewed 171 patients undergoing late second-trimester D&E procedures. Follow-up, available for 150 women, revealed 61
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Reprint requests: Robin B. Kalish, MD, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, 525 E 68th St, Room J-130, New York, NY 10021. E-mail: [email protected]