Risk factors predisposing to surgical evacuation after medical termination of pregnancy during the second trimester: A retrospective study

Abstract

Purpose: To investigate the possible risk factors which might increase the likelihood of surgical evacuation after medical termination of pregnancy during the second trimester.
Methods: Data derived from 262 women who had undergone medical termination of pregnancy during her second trimester in a tertiary care center between January 2009- February 2013 were retrospectively analyzed. Misoprostol was administered vaginally at intervals of 4-6 hours at a total dose of 100-4400 mg for medical termination.
Results: Surgical evacuation was performed at a rate of 19.8 percent (52/262). Indications for surgical evacuation were incomplete abortion in 37, and failure of medical induction of abortion in six patients. Total dose of misoprostol, time to abortion after induction, duration of hospitalization, systolic blood pressure at admission and baseline hematocrit levels, occurrence of side effects of misoprostol seem to increase the likelihood of a surgical procedure for definite termination of a second- trimester pregnancy.
Conclusion: Both surgical evacuation as well as medical induction of abortion can be utilized for termination of second- trimester pregnancies. Surgical evacuation should be considered in case of failure of induction, incomplete abortion or for hemodynamically instable patients. Correct and timely decision for the selection of an appropriate method is crucial to avoid hazardous outcomes.