Using prophylactic antihemorrhagic medications in second-trimester surgical abortions


Aurora University of Wisconsin Medical Group, Aurora Sinai Medical Center, Advocate Aurora Research Institute, Aurora West Allis Medical Center


We aimed to estimate the association of prophylactic antihemorrhagic medication use during dilation and evacuation (D&E) with operative hemorrhage and estimated blood loss (EBL). Records for all pregnant patients between 14 and less than 22 weeks of gestation who had a D&E procedure from January 2012 to December 2019 were retrospectively reviewed. Prophylactic antihemorrhagic medication use was defined as receiving vasoconstrictors, uterotonics, or both before identification of hemorrhage during a D&E procedure. Overall, 147 D&E procedures were completed at a mean of 16.4 (±2.2) weeks of gestation. Prophylactic medications were used in 72.1% (n=106) of D&E procedures. Prophylactic medication use was associated with lower operative hemorrhage (21.7% vs 51.2%, P < .01) and lower EBL (336.9 mL vs 551.3 mL, P < .01).



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