Impact of midtrimester dilation and evacuation on subsequent pregnancy outcome

Am J Obstet Gynecol. 2002 Oct;187(4):882-5. doi: 10.1067/mob.2002.127139.


Objective: This study was undertaken to evaluate the impact of second-trimester dilation and evacuation (D&E) on subsequent pregnancy outcome.

Study design: Medical record review of 600 patients undergoing midtrimester (14-24 weeks) D&E from 1996 to 2000 and evaluation of subsequent pregnancy outcome. Mann Whitney U, Spearman rho, and chi(2) tests were used in statistical analysis with a P value <.05 considered significant.

Results: Ninety-six subsequent pregnancies were identified, including 12 first-trimester spontaneous abortions, 1 second-trimester fetal death, 1 ectopic pregnancy, and 5 elective terminations. Seventy-seven pregnancies resulted in the delivery of a live-born infant at a median gestational age of 39.0 weeks. Five pregnancies (6.5%) were complicated by spontaneous preterm birth. Patients delivered preterm had an earlier gestational age at D&E (18.0 vs 20.0 weeks, P =.02) and a trend toward less preoperative cervical dilation (2.0 vs 3.0 cm, P =.09) than patients delivered at term.

Conclusion: Second-trimester D&E is not a risk factor for midtrimester pregnancy loss or spontaneous preterm birth. Preterm delivery in future gestations appears less likely when greater preoperative cervical dilation is achieved with laminaria, possibly because of a decrease in cervical trauma.

MeSH terms

  • Abortion, Induced / methods*
  • Adult
  • Dilatation and Curettage* / adverse effects
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Labor Stage, First
  • Medical Records
  • Obstetric Labor, Premature / etiology
  • Obstetrical Forceps
  • Parity*
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy Trimester, Second
  • Retrospective Studies
  • Risk Factors