• DOI:10.1097/01.AOG.0000431056.79334.cc
• Corpus ID: 205384119

Practice Bulletin No. 135: Second-Trimester Abortion

@article{2013PracticeBN,
  title={Practice Bulletin No. 135: Second-Trimester Abortion},
  author={},
  journal={Obstetrics \& Gynecology},
  year={2013},
  volume={121},
  pages={1394–1406}
}

• Published 1 June 2013
• Medicine
• Obstetrics & Gynecology

Second-trimester abortion is an important component of comprehensive women’s health care, and women seek termination later in pregnancy for a variety of medical and social reasons. Circumstances that can lead to second-trimester abortion include delays in suspecting and testing for pregnancy, delay in obtaining insurance or other funding, and delay in obtaining referral, as well as difficulties in locating and traveling to a provider (5). Poverty, lower education level, and having multiple disruptive life events, have been associated with higher rates of seeking second-trimester abortion (3). In addition, major anatomic or genetic anomalies may be detected in the fetus in the second trimester and women may choose to terminate their pregnancies (47–95%) (6–8). The identification of major anatomic or genetic anomalies in the fetus through screening and diagnostic testing most commonly occurs in the second trimester, although first-trimester screening and chorionic villus sampling can enable first-trimester diagnosis of aneuploidy. Some obstetric and medical indications for second-trimester termination include preeclampsia and preterm premature rupture of membranes, among other conditions. Additional indications for uterine evacuation in the second trimester are pregnancy failure before 20 weeks of gestation and fetal demise. In 2005, the U.S. fetal mortality rate was 6.22 fetal deaths at 20 weeks of gestation or more per 1,000 live births and fetal deaths, and this rate was higher for teenagers; women aged 35 years and older; and among non-Hispanic black, Hispanic, and American Indian or Alaska Native women (9).