DEATHS FROM 2ND TRIMESTER ABORTION BY DILATATION AND EVACUATION - CAUSES, PREVENTION, FACILITIES

  • 1 January 1981
    • journal article
    • research article
    • Vol. 58  (4) , 401-408
Abstract
In 1978, dilatation and evacuation (D and E) became the leading method of abortion at 13 wk gestation or later in the USA. The increasing popularity of D and E reflects its relative advantages in safety, convenience, expense and speed when compared with alternate methods. All reported deaths from D and E in the USA between Jan. 1, 1972 and Dec. 31, 1978 were reviewed. The predominant causes of death were infection and hemorrhage. Both race and gestational age significantly influence the death:case rate for D and E procedures. White women had a 3-fold lower risk of dying from d and E than women of other races. D and E procedures performed at 13-15 wk gestation were nearly 3 times safer than those performed at 16 wk or later. D and E performed in nonhospital settings did not have higher death:case rates than those performed in hospitals. Comparative mortality data suggest abortion by D and E at 13 wk gestation or later is more dangerous than suction curettage performed earlier in gestation, but safer than instillation techniques performed later. The advantage of D and E occurs largely in the 13- to 15-wk gestation interval, i.e., at the beginning of the 2nd trimester. Policy makers should reconsider laws requiring all 2nd trimester abortions to be performed in hospitals. Based on these data, 16 wk gestation would be a more appropriate threshold at present.