Midtrimester Dilatation and Evacuation Abortion

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Abstract
At a university referral hospital where midtrimester abortions are performed by prostaglandin F2 alpha instillation, interest in reports of lower morbidity with dilatation and evacuation (D&E) led to the development of a D&E technic for outpatient use at 13 to 16 weeks' gestation. Of the first 19 women offered this method instead of the standard hospitalization and prostaglandin instillation, all 19 accepted. The D&E technic for pregnancies greater than or equal to 15 weeks' gestation included overnight laminaria treatment, intracervical block using lidocaine with epinephrine, and Bierer forceps for extraction. There were no complications. This favorable initial experience indicates the need for evaluation of the comparative safety of midtrimester abortion by D&E versus instillation of prostaglandin F2 alpha.

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