Dilation and evacuation
| Background | |
| Abortion type | Surgical |
| First use | 1970s |
| Gestation | 13-24 weeks |
| Usage | |
| UK: Eng. & Wales | 5% (2005) |
In methods of abortion, dilation and evacuation (D&E also sometimes called dilation and extraction) is the dilation of the cervix and surgical evacuation of the contents of the uterus. It is a method of abortion as well as a therapeutic procedure used after miscarriage to prevent infection by ensuring that the uterus is fully evacuated.
In various health care centers it may be called by different names:
D&E normally refers to a specific second trimester procedure. However, some sources use the term D&E to refer more generally to any procedure that involves the processes of dilation and evacuation, which includes the first trimester procedures of manual and electric vacuum aspiration.
Dilation and evacuation (D&E) is one of the methods available for a second-trimester abortion. A D&E is done to completely remove all of the tissue in the uterus for an abortion in the second trimester of pregnancy.
A D&E is recommended for women diagnosed in the second trimester with a fetus that has severe medical problems or abnormalities. Abnormalities such as severe neural tube defects or congenital heart anomalies are typically diagnosed by ultrasound during weeks 18-23, because detailed anatomy cannot be fully evaluated before that time due to requirements for fetal size.
When an abortion is delayed, a D&E may be necessary.
Approximately 11% of induced abortions are performed in the second trimester. In 2002, there were an estimated 142,000 second-trimester abortions in the United States. The second trimester of pregnancy begins at 13 weeks gestation. For first-trimester and early second-trimester abortions, the pregnancy may be ended by vacuum aspiration alone. Sometimes in the second trimester, however, it becomes necessary to use instruments to remove the fetus. This instrumental procedure is normally what is meant when the term dilation and evacuation is used.
The first step in a D&E is to dilate the cervix. This is often begun about a day before the surgical procedure, and often involves the insertion of multiple laminaria sticks into the cervix. Enlarging the opening of the cervix enables surgical instruments such as a curette or forceps to be inserted into the uterus.
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