Surgical versus medical methods for second trimester induced abortion.

@article{Lohr2008SurgicalVM,
  title={Surgical versus medical methods for second trimester induced abortion.},
  author={Patricia A Lohr and Jennifer L. Hayes and Kristina Gemzell‐Danielsson},
  journal={The Cochrane database of systematic reviews},
  year={2008},
  volume={1},
  pages={
          CD006714
        }
}
BACKGROUND Determining the optimal method of performing second-trimester abortions is important, since they account for a disproportionate amount of abortion-related morbidity and mortality. OBJECTIVES To compare surgical and medical methods of inducing abortion in the second trimester of pregnancy with regard to efficacy, side effects, adverse events, and acceptability. SEARCH STRATEGY We identified trials using Pub Med, EMBASE, POPLINE, and the Cochrane Central Register of Controlled… 
Complications after Second Trimester Surgical and Medical Abortion
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Current evidence suggests that, given trained providers and where otherwise feasible, D&E is preferable to medical induction, and a larger randomised controlled trial is needed that directly compares outcomes between the two methods.
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TLDR
Based on this evidence and consensus, women should be offered the choice of medical or surgical methods of abortion between 13+0 and 23+6 weeks’ gestation, unless not clinically appropriate.
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TLDR
Medical abortion in the second trimester using the combination of mifepristone and misoprostol appeared to have the highest efficacy and shortest abortion time interval.
Medical treatments for incomplete miscarriage.
TLDR
The effectiveness, safety, and acceptability of any medical treatment for incomplete miscarriage (before 24 weeks), or alternative methods of medical treatment, with randomised controlled trials comparing medical treatment with expectant care or surgery, is assessed.
Uterine Rupture in Second-Trimester Misoprostol-Induced Abortion After Cesarean Delivery: A Systematic Review
  • V. Goyal
  • Medicine
    Obstetrics and gynecology
  • 2009
TLDR
The risk of uterine rupture among women with a prior cesarean delivery undergoing second-trimester abortion using misoprostol is less than 0.3%, which may be acceptable to both patients and providers.
Medical treatments for incomplete miscarriage (less than 24 weeks).
TLDR
The available evidence suggests that medical treatment, with misoprostol, and expectant care are both acceptable alternatives to routine surgical evacuation given the availability of health service resources to support all three approaches.
A review of evidence for safe abortion care.
TLDR
The available evidence does not support the use of pre-abortion ultrasound to increase safety, and women who are eligible should be offered a choice between surgical and medical methods of abortion when possible.
Update on second-trimester surgical abortion
TLDR
The use of mifepristone and misoprostol for second-trimester abortion has improved safety and efficacy of medical and surgical methods when used alone or in combination and as adjuncts to osmotic dilators.
Termination of pregnancy and unsafe abortion.
  • L. Lim, Kuldip Singh
  • Medicine
    Best practice & research. Clinical obstetrics & gynaecology
  • 2014
TLDR
Clinical guidelines should be available in all healthcare sectors providing abortion services to ensure a uniformly high standard of care for all women requesting abortions and services should ensure that written, objective, evidence-guided information is available for women considering abortion to take away before the procedure, including complications and sequelae of abortion.
Surgical and medical second trimester abortion in South Africa: A cross-sectional study
TLDR
As currently performed in South Africa, second trimester abortions by D&E were more effective than induction procedures, required shorter hospital stay, had fewer major immediate complications and were associated with shorter delays accessing care.
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