MEDICAL EBOOK DOWNLOAD, American Journal of Obstetrics & Gynecology AUGUST 2009, Safety of late second-trimester pregnancy termination by laminaria dilatation and evacuation in patients with previous multiple cesarean sections

MEDICAL EBOOK DOWNLOAD

American Journal of Obstetrics & Gynecology AUGUST 2009

Safety of late second-trimester pregnancy termination by laminaria dilatation and evacuation in patients with previous multiple cesarean sections


DOWNLOAD:
Safety_of_late_second-trimester_pregnancy_termination_by_laminaria_dilatation_and_evacuation_in_pati



OBJECTIVE: To assess whether there is an increased perioperative risk
in termination of late second-trimester pregnancy after multiple cesarean
sections by laminaria dilatation and evacuation.

STUDY DESIGN: During the period between January 2002 and June
2008, 636 consecutive patients underwent late second-trimester
(17-24 weeks) pregnancy terminations by dilatation and evacuation.
Patients were divided into 3 subgroups: those with no previous
cesarean section (n = 545), those with 1 previous cesarean
section (n = 59), and those with several previous cesarean sections
(n = 32).

RESULTS: There were no significant differences in major perioperative
complications, such as anesthetic complications, need for blood transfusion,
and cervical lacerations comparing the 3 subgroups. Importantly,
there were neither cases of uterine perforation nor retained products
of conception in the 3 subgroups.

CONCLUSION: Late second-trimester pregnancy termination after multiple
cesarean sections by laminaria dilatation and evacuation is probably
not associated with an increased perioperative risk. Larger studies
are needed to empower this study.

Key words: cesarean section, dilatation and evacuation, late
abortion, scarred uterus