Abstract

At a university referral hospital where midtrimester abortions are performed by prostaglandin F2α 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 ≥ 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 F2α.