Issues in second trimester induced abortion (medical/surgical methods)

Second trimester abortion remains a common procedure worldwide Dilatation and evacuation (D&E) is the surgical method of choice, if the surgical expertise and facilities are available Adequate cervical dilatation preoperatively is a prerequisite for a safe D&E Medical abortion using misoprostol together with mifepristone is the medical method of choice. The recommended regimen is 200 mg mifepristone followed by 800 mu g of vaginal misoprostol 36-48 h later Subsequent doses of 400 mu g of misoprostol can be given orally every 3 h up to a maximum of four more doses Proper preoperative assessment would not only help to provide safe abortion treatment. but it also guides the choice of method If the expertise and facilities of both methods are available, both methods should be discussed and offered to the patient so that the patient can make an informed choice (C) 2010 Elsevier Ltd. All rights reserved