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Comparative Study
Journal Article
Interpregnancy interval and subsequent pregnancy outcomes after dilation and evacuation.
Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology 2018 May
We conducted this study to compare outcomes for pregnancies conceived ≤6 months after dilation and evacuation (D&E) with those conceived >6 months after D&E. This retrospective cohort study included women who underwent D&E (14-26 weeks) and were readmitted with a subsequent pregnancy. The primary outcome was the rate of preterm birth (<37 weeks). We identified 737 D&Es with 214 subsequent pregnancies. Outcomes were available for 85.5% of these pregnancies. Preterm birth <37 weeks occurred in 9.4% (3/32) of patients with an interpregnancy interval ≤6 months and 20.7% (12/58) of patients with an interpregnancy interval >6 months (p = .17). No differences in preterm birth <34 weeks, postpartum haemorrhage, placentation abnormalities, intrauterine growth restriction, cervical insufficiency or mode of delivery were noted. Adverse pregnancy outcomes were not higher in the group of women who conceived ≤6 months after D&E compared to those who waited longer than 6 months. IMPACT STATEMENT What is already known on this subject: A small number of studies have noted an increased risk of adverse pregnancy outcomes with an interpregnancy interval of 6 months or fewer after a spontaneous or an induced abortion. What the results of this study add: We present the first study exploring pregnancy outcomes after dilation and evacuation for termination of pregnancy at 14 weeks or greater. Our results do not support an increased rate of adverse events with an interpregnancy interval of 6 months or fewer following dilation and evacuation. What the implications are of these findings for clinical practice and/or further research: Because of limitations in sample size, our results should be interpreted in the context of other studies.
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