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  • Title: Methods of midtrimester abortion.
    Author: Smith T.
    Journal: Fertil Contracept; 1979 Oct; 3(4):53-9. PubMed ID: 12336079.
    Abstract:
    The midtrimester abortion is performed more frequently in England and Wales than in any other country with leberal abortion laws. The majority of midtrimester abortions, over 80%, take place before 17 weeks and about 1 in 20 after 20 weeks. It is important to reduce the number of late terminations, because morbidity and mortality rise with increasing gestation. The methods available and techniques used are reviewed along with complications. Dilatation and evacuation of the uterus using sponge forceps, is the preferred method of terminating pregnancies up to 16 weeks. From this point onwards the instillation of intraamniotic urea and prostaglandin is the safest and most certain method of terminating pregnancy, although it is unpleasant for the woman and may be upsetting for the medical and nursing staff. Midtrimester abortions share the same problems as 1st trimester abortions and complications such as hemorrhage, infection, retained products, uterine trauma, and thromboembolic disease occur with increasing frequency as gestation advances up to 20 weeks. Specific problems which may occur are water-intoxication with syntocinon induced or augmented abortions, gastrointestinal side-effects with prostaglandins, disseminated intravenous coagulation and cerebral hemorrhage with saline abortions and infection if glucose is used. It may be preferrable to perform the abortion under an anesthetic rather than when the woman is conscious if she is very young, extremely disturbed psychologically, or severely mentally handicapped.
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