USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

Table I-2-1. Methods    of  Induced Abortion

Trimester Method Procedure Maternity-Mortality
Ratio

First Trimester Surgical Suction dilation & curettage (D&C) 1

Medical Mifepristone    (progesterone

antagonist)

1

Second
Trimester

Surgical Dilation   &   evacuation  (D&E) 4

PGE 1 Induction of  labor   contractions 8

Any Trimester Major
surgery

Hysterotomy,    hysterectomy 25

cervix  can be  achieved    with    prostaglandins  (intra-amniotic PGF2α), vaginal

PGE 2   (dinoprostone), IM  15-methyl   PGF2α   (carboprost tromethamine),  or

PGE 1   (misoprostol).  Interval    from    induction   to  delivery    may be  up  to  24

hours.

Delivery    of  a   live    fetus   may occur   with    use of  prostaglandin   (PG)

analogs;    feticidal   agents  used    include intracardiac    injection   of  KCl or

digoxin.

Immediate   complications   include retained    placentae   (the    most    common

problem with    all PG  abortions), hemorrhage, and infection.  Delayed

complications   include cervical    trauma  with    resulting   cervical

insufficiency.  Maternal    mortality   ratio   is  8   per 100,000 women.