Induction of labor compared to dilation and evacuation for postmortem analysis

• Published in: Prenatal diagnosis Vol. 34; no. 6; pp. 547 - 551
• Main Authors: Lal, A. K., Kominiarek, M. A., Sprawka, N. M.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.06.2014; Wiley Subscription Services, Inc
• Subjects: Aborted Fetus - pathology; Abortion, Induced - adverse effects; Abortion, Induced - methods; Abortion, Induced - statistics & numerical data; Adolescent; Adult; Autopsy; Cytogenetic Analysis; Dilatation and Curettage - adverse effects; Dilatation and Curettage - methods; Dilatation and Curettage - statistics & numerical data; Female; Humans; Labor, Induced - adverse effects; Labor, Induced - methods; Labor, Induced - statistics & numerical data; Middle Aged; Postoperative Complications - epidemiology; Postoperative Complications - pathology; Pregnancy; Retrospective Studies; Young Adult
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.4346

ABSTRACT ObjectiveThis study aimed to evaluate the ability to obtain autopsy and cytogenetics after midtrimester termination. MethodsA retrospective cohort study of women undergoing termination, via induction or dilation and evacuation (D&E), at 16 0/7–23 6/7 weeks was performed. Exclusion criteria were elective termination, preterm labor, PPROM, and no autopsy or cytogenetic exam performed. The ability to obtain cytogenetics and autopsy as well as complications rates were compared between the two groups with Chi‐square tests. ResultsOf the 469 women who met the inclusion criteria, 158 had an induction and 312 had a D&E. The induction of labor group had higher mean gestational ages, p < 0.01. Successful autopsy was more likely in the induction group, 94.3%, versus D&E group, 34.7%, p = 0.01. There was no difference in ability to obtain cytogenetics between the two groups, 89.1% in the induction group, and 92.3% in D&E group, p = 0.4. There was a difference in the total complication rates between the groups, 9.8% (26) in the induction versus 6.4% (20) in the D&E group, p < 0.01; however, there was no difference in major complications. ConclusionsMidtrimester terminations by induction were more likely to have successful autopsies when compared with D&E. The ability to obtain cytogenetics was similar regardless of termination mode. © 2014 John Wiley & Sons, Ltd. What's already known about this topic? Postmortem examination, including autopsy and cytogenetic, can be used to confirm or add information to a prenatal diagnosis. D&E has been shown to have fewer complications than IOL, but the ability to obtain autopsy is controversialWhat does this study add? This study compares the two modes of termination and their ability to obtain autopsy and cytogenetics.