Second Trimester Abortion Safety Considerations

Surgical and Medical Methods

The European Society of Cardiology recommends that second trimester abortions should be performed in a healthcare facility where blood transfusion and emergency surgery are available 1, 2
Dilatation and evacuation is the safest procedure in both first and second trimesters if surgical evacuation is feasible, according to the European Heart Journal 1, 2
If surgical evacuation is not feasible, medical methods using prostaglandins can be administered, as stated by the European Heart Journal 1, 2

The American Academy of Family Physicians recommends that misoprostol should be avoided in women with previous cesarean delivery due to the risk of uterine rupture 3, 4
When prostaglandin E compounds are administered, systemic arterial oxygen saturation should be monitored with a transcutaneous pulse oximeter, according to the European Heart Journal 1, 2
Norepinephrine may be needed to support diastolic blood pressure, which reflects systemic vascular resistance, as stated by the European Heart Journal 1, 2
Prostaglandin F compounds should be avoided as they can significantly increase pulmonary arterial pressure and decrease coronary perfusion, according to the European Heart Journal 1, 2

Side effects of misoprostol include gastrointestinal symptoms, fever/rigors, and pain, as reported by the American Academy of Family Physicians is not the source of this fact, instead it is from Praxis Medical Insights but we will use 6
Medical management avoids anesthesia risks and surgical complications such as uterine perforation, cervical trauma, and Asherman syndrome 6