Risk factors of surgical evacuation following second-trimester medical termination of pregnancy

BackgroundSecond-trimester medical termination of pregnancy (TOP) is associated with a higher risk of surgical evacuation than earlier medical TOP. Little is known about risk factors of surgical evacuation. Therefore, we assessed these risk factors among women undergoing second-trimester medical TOP.Study DesignData on 227 women were derived from a prospective randomized trial comparing 1- and 2-day mifepristone–misoprostol intervals in second-trimester medical TOP between 2008 and 2010.ResultsThe rate of surgical evacuation was 30.8%. The risk of surgical evacuation was increased by a history of curettage [odds ratio (OR) 4.4; 95% confidence interval (CI) 1.7–11.7], fetal indications for TOP (OR 6.1; 95% CI 1.1–34.4), age above 24 years (OR 2.4; 95% CI 1.1–5.3) and a 2-day interval (OR 2.2; 95% CI 1.1–4.1).ConclusionsHistory of curettage, fetal indication, increasing age and 2-day interval between mifepristone and misoprostol increase the risk of surgical evacuation in cases of second-trimester medical TOP. These findings are important when optimizing clinical service in second-trimester TOP.