Complication rates of dilation and evacuation and labor induction in second-trimester abortion for fetal indications: A retrospective cohort study

Objective: To compare complication rates of dilation and evacuation (D&E) to mifepristone and misoprostol labor induction for second trimester abortion for fetal indications. Study design: We performed a retrospective cohort study comparing complication rates with D&E and labor induction abortion for fetal indications at 14 weeks 0 days through 23 weeks and 6 days gestation between January 1, 2009, and August 31, 2017. We extracted demographic, procedural, and outcome data, focusing specifically on complications of maternal hemorrhage, infection, emergency department visit, hospital readmission, retained tissue requiring dilation and curettage (D&C), manual placental removal, or thromboembolism. We compared complication rates between the D&E and induction groups using univariate and multivariate analyses. Results: We included outcomes from 75 (48%) D&E and 81 (52%) labor induction abortions. We identified any complication in 1 (1%) and 7 (7%) of patients, respectively (p = 0.12). The only complication in the D&E group was hemorrhage with an estimated blood loss of 1000 mL not requiring transfusion. Labor induction complications included retained tissue requiring manual removal (n = 2) or D&C (n = 1) and hemorrhage (n = 2). Conclusion: There was no difference in complication rates between the D&E group and the labor induction group. (C) 2020 Elsevier Inc. All rights reserved.