{
    "abstract": "Dilation-and-evacuation procedures were performed on 13 critically ill women between 20 and 24 weeks of gestation. There were no complications. The procedure can play a significant role in the management of selected critically ill women.\nA review of 13 cases of second trimester termination at 20-24 weeks by dilation and evacuation after insertion of laminaria in women with critical illness is presented. The patients ranged in age from 17-41, parity from 0-5, and diagnoses covered a wide range, including hematologic, respiratory, vascular, gastrointestinal, cardiac systems, malignancies, autoimmune disorders and infections, as well as several with multiple problems, including intravenous drug use. Most were the result of late diagnosis or late presentation. Procedures were performed according to a standard protocol by 1 physician, from 1983- 1987, using iv meperidine and diazepam sedation and paracervical block, 12 after laminaria insertion. Amniotomy and evacuation with large ovum forceps were followed by oxytocin and sharp curettage. There were no complications in this series. The dilation and curettage method is preferable in such cases because the timing of the procedure can be planned for maximal use of facilities and staff, the patient is spared by unattended delivery, the length of the abortion process is minimal, and incidence of infection and retained placenta is lower. Need for lengthy analgesia and fluid monitoring is reduced, an advantage for many critically ill women. This approach is best done by a physician with specific experience, in a setting capable of managing severe complications.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, New York 10029.",
            "firstname": "C H",
            "initials": "CH",
            "lastname": "Bowers"
        },
        {
            "affiliation": null,
            "firstname": "J L",
            "initials": "JL",
            "lastname": "Chervenak"
        },
        {
            "affiliation": null,
            "firstname": "F A",
            "initials": "FA",
            "lastname": "Chervenak"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": null,
    "journal": "The Journal of reproductive medicine",
    "keywords": [
        "Abortion, Induced",
        "Abortion, Therapeutic",
        "Americas",
        "Antibodies",
        "Autoimmune Response",
        "Biology",
        "Blood Coagulation Effects",
        "Case Studies",
        "Curettage",
        "Developed Countries",
        "Diseases",
        "Embolism",
        "Family Planning",
        "Fertility Control, Postconception",
        "Gastrointestinal Effects",
        "Heart Diseases",
        "Hematological Effects",
        "Hemic System",
        "Hereditary Diseases",
        "High Risk Women",
        "Hypertension",
        "Immunity",
        "Immunologic Factors",
        "Infections",
        "Neoplasms",
        "New York",
        "North America",
        "Northern America",
        "Obstetrical Surgery",
        "Physiology",
        "Pregnancy",
        "Pregnancy Complications",
        "Pregnancy, Second Trimester",
        "Pulmonary Effects",
        "Pulmonary Embolism",
        "Reproduction",
        "Research Methodology",
        "Respiratory Insufficiency",
        "Studies",
        "Surgery",
        "Treatment",
        "United States",
        "Vascular Diseases"
    ],
    "methods": null,
    "publication_date": "1989-11-01",
    "pubmed_id": "2585388",
    "results": null,
    "title": "Late-second-trimester pregnancy termination with dilation and evacuation in critically ill women.",
    "xml": "<Element 'PubmedArticle' at 0x788502ed82c0>"
}