Uterine curettage following second trimester abortion by extraovular instillation of prostaglandin E-2 - A prospective-randomized trial

Objective: To evaluate the benefits associated with routine uterine curetta ge following complete second trimester termination of pregnancy by extraovu lar prostaglandin E-2. Study design: Fifty-five patients between 15 and 24 weeks' gestation who had undergone complete termination of pregnancy by con tinuous extraovular instillation of prostaglandin E-2 (PGE(2)), were random ly assigned into either no further intervention (n=25), or uterine curettag e under general anesthesia (n=30). The need for late uterine curettage, cli nical and ultrasonographic parameters at 1 and 42 days follow-up, as well a s the incidence of the minor and major complications, were compared between groups. Results: Baseline and post-abortion clinical and ultrasonographic characteristics were similar in both groups. Mean (+/- Standard error of th e mean) number of post-abortion bleeding days in the curettage group was 8. 9+/-1.8 versus 10.1+/-2.6 days in the non-curettage group (P=NS). No patien t in the former group, compared to three patients in the latter group, need ed late uterine curettage, (P=NS). Major and minor complications rates in t he curettage and in the no-curettage groups were not significantly differen t. Considerably more patients in the curettage group needed analgesic agent s following the abortion compared to the no-curettage group (60% vs. 3.3%, respectively; P<0.001). Conclusions: Routine uterine curettage in patients undergoing complete second trimester termination of pregnancy by extraovula r instillation of PGE(2) exerts no benefit. (C) 1999 Elsevier Science Irela nd Ltd. All rights reserved.