Methods of Midtrimester Abortion: Which Is Safest?

In the United States, the three principal methods of abortion for patients at 13 or more menstrual weeks' gestation are intraamniotic instillation of saline or prostaglandin F2α (PGF2α) and dilatation and evacuation (D&E). The relative safety of these methods, however, has not been established. This report compares the three methods using data on 17467 abortions collected by the Joint Program for the Study of Abortion under the auspices of the Center for Disease Control (JPSA/CDC). Abortion by D&E was found to be significantly safer than abortion by saline instillation (p<0.001), and abortion by saline instillation was significantly safer than by PGF2α (p<0.01). Moreover, midtrimester D&E is both safe and practical; it is a direct and rapid procedure which can be performed on an outpatient basis. Although PGF2α accelerated the time required for abortion, it also significantly increased serious morbidity.

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