The Experts below are selected from a list of 1791 Experts worldwide ranked by ideXlab platform

Jennifer L. Kerns - One of the best experts on this subject based on the ideXlab platform.

  • A randomized controlled trial of methylergonovine prophylaxis after Dilation and Evacuation abortion.
    Contraception, 2020
    Co-Authors: Jennifer L. Kerns, Rebecca A Jackson, Geffan Pearlson, Biftu Mengesha, Kristin Harter, Eleanor A Drey
    Abstract:

    Abstract Objective To evaluate the efficacy of intramuscular methylergonovine maleate as prophylaxis against excessive bleeding when given after Dilation and Evacuation (D&E) at 20–24 weeks. Study design We performed a randomized, double-blinded, placebo-controlled trial in patients without excessive bleeding requiring intervention after D&E completion. We administered study treatment within one minute of the end of the procedure. We primarily compared outcomes using a composite of indicators of excessive post-procedure blood loss (post-procedure measured blood loss exceeding 125 mL, uterine massage or compression for at least two minutes, administration of additional uterotonic medication, intrauterine balloon tamponade, uterine re-aspiration, blood transfusion, uterine artery embolization, hospital admission for bleeding, or major surgery). Secondary outcomes included individual indicator occurrences, satisfaction, and side effects. Results From March 3, 2015 to March 31, 2017, we randomized 284 participants (n = 140 methylergonovine, n = 144 placebo), five before we registered the trial with clinicaltrials.gov. Baseline characteristics were similar between groups. The composite outcome occurred in 78 (56%) methylergonovine and 75 (52%) placebo participants (p = 0.5). Methylergonovine recipients required more intrauterine balloon use (n = 20 [14%]) versus placebo (n = 10 [7%]), p = 0.04. We also observed a non-significant trend towards more uterotonic administration (n = 56 [40%] versus n = 43 [30%], p = 0.07) and hospital admissions for bleeding (n = 4 [3%] versus n = 0, p = 0.06) in the methylergonovine group compared to placebo. Conclusion We observed no improvement in the composite outcome for excessive bleeding with prophylactic post-procedure methylergonovine. In addition, individual excessive bleeding outcomes occurred more frequently in the methylergonovine group, potentially indicating harm with its prophylactic use after D&E. Implications When administered prophylactically immediately after Dilation and Evacuation abortion at 20–24 weeks, methylergonovine increases uterine bleeding. Given the lack of data for effectiveness as a prophylactic agent and our findings indicating harm, we do not recommend its use for post-operative prophylaxis.

  • disseminated intravascular coagulation and hemorrhage after Dilation and Evacuation abortion for fetal death
    Obstetrics & Gynecology, 2019
    Co-Authors: Jennifer L. Kerns, Abby Sokoloff, S. Aksel, Lauren Lederle, Jody Steinauer
    Abstract:

    OBJECTIVE To examine the association between fetal death and risk of hemorrhage and disseminated intravascular coagulation (DIC) among women undergoing Dilation and Evacuation (D&E) procedures. METHODS We conducted a retrospective cohort study of all D&Es at one academic abortion clinic in San Francisco between 2009 and 2013. We abstracted data on fetal death status, demographic characteristics, and complications including hemorrhage and DIC. We examined the risk of hemorrhage and DIC among women with fetal death compared with those without. We conducted unadjusted and adjusted analyses for the outcomes of hemorrhage, DIC, and any complication. RESULTS Among 92 cases of D&E for fetal death and 4,428 cases of D&E for other reasons, hemorrhage occurred in 10% and 7%, respectively (P=.28), and DIC occurred in 2.0% and 0.2% of the fetal death and nonfetal death cohorts (P<.001). In adjusted analysis, fetal death was associated with 2.9 times higher odds of hemorrhage (95% CI 1.4-6.0). In an unadjusted analysis, fetal death was associated with 12.3 times higher odds of DIC (95% CI 2.6-58.6) and 3.0 times higher odds of any complication (95% CI 1.6-5.9). CONCLUSION Women undergoing D&E for fetal death are far more likely to experience DIC and hemorrhage than are women without fetal death, yet the absolute risk is low (2%). Although D&E providers should be prepared for DIC and hemorrhage, we do not recommend any specific preoperative preparation because the vast majority of D&E abortions for fetal death are uncomplicated.

  • Disseminated Intravascular Coagulation and Hemorrhage After Dilation and Evacuation Abortion for Fetal Death.
    Obstetrics and gynecology, 2019
    Co-Authors: Jennifer L. Kerns, Abby Sokoloff, S. Aksel, Lauren Lederle, Jody Steinauer
    Abstract:

    OBJECTIVE To examine the association between fetal death and risk of hemorrhage and disseminated intravascular coagulation (DIC) among women undergoing Dilation and Evacuation (D&E) procedures. METHODS We conducted a retrospective cohort study of all D&Es at one academic abortion clinic in San Francisco between 2009 and 2013. We abstracted data on fetal death status, demographic characteristics, and complications including hemorrhage and DIC. We examined the risk of hemorrhage and DIC among women with fetal death compared with those without. We conducted unadjusted and adjusted analyses for the outcomes of hemorrhage, DIC, and any complication. RESULTS Among 92 cases of D&E for fetal death and 4,428 cases of D&E for other reasons, hemorrhage occurred in 10% and 7%, respectively (P=.28), and DIC occurred in 2.0% and 0.2% of the fetal death and nonfetal death cohorts (P

  • A qualitative study of digoxin injection before Dilation and Evacuation.
    Contraception, 2018
    Co-Authors: Blair Mcnamara, Jennefer A. Russo, Sarina Chaiken, Janet C. Jacobson, Jennifer L. Kerns
    Abstract:

    Abstract Objective We sought to qualitatively understand patients’ experiences with digoxin as a step before Dilation and Evacuation (DE we stopped recruitment when we reached thematic saturation. Results We conducted 20 interviews and participants described mixed experiences. Three overarching themes from the qualitative interviews were: (1) physical and emotional discomfort; (2) varied understanding of digoxin’s purpose and effects; and (3) reassurance. Most participants described significantly negative experiences with digoxin; however, many participants also described positive aspects of the injection intermingled with those negative experiences. Conclusions Participants’ experiences with digoxin before D&E were both polarized and nuanced. While participants were largely clear about digoxin’s action, they were much less clear about the reason for its use. Implications Both the clinical purpose for and patients’ experiences with digoxin before D&E are complicated. Providers who continue to use digoxin should consider patient preferences in how they offer digoxin, and consider tools to ensure patient understanding.

  • Estimated versus measured blood loss during Dilation and Evacuation: an observational study
    Contraception, 2018
    Co-Authors: Elissa T. Serapio, Geffan Pearlson, Eleanor A Drey, Jennifer L. Kerns
    Abstract:

    Abstract Objective To compare estimated versus measured blood loss at the time of Dilation and Evacuation (DE we excluded 163 procedures because of failure to measure blood loss or contamination with amniotic fluid. Included and excluded procedures had similar median EBLs. Median EBL differed significantly from MBL for each week gestation from 16 to 24 weeks (p≤.001 for all comparisons); MBL was approximately twice as high as EBL for each gestational week. EBL and MBL increased with increasing gestation, as did the difference between EBL and MBL. Conclusion Providers consistently and significantly underestimate blood loss at the time of D&E. D&E providers may want to consider using a new heuristic for estimating blood loss. Implications Providers significantly underestimate blood loss at the time of D&E. Future research should confirm these findings (particularly at 22–24 weeks gestation), evaluate the efficacy of interventions to improve estimations of blood loss, and determine best practices for decreasing blood loss.

Eleanor A Drey - One of the best experts on this subject based on the ideXlab platform.

  • A randomized controlled trial of methylergonovine prophylaxis after Dilation and Evacuation abortion.
    Contraception, 2020
    Co-Authors: Jennifer L. Kerns, Rebecca A Jackson, Geffan Pearlson, Biftu Mengesha, Kristin Harter, Eleanor A Drey
    Abstract:

    Abstract Objective To evaluate the efficacy of intramuscular methylergonovine maleate as prophylaxis against excessive bleeding when given after Dilation and Evacuation (D&E) at 20–24 weeks. Study design We performed a randomized, double-blinded, placebo-controlled trial in patients without excessive bleeding requiring intervention after D&E completion. We administered study treatment within one minute of the end of the procedure. We primarily compared outcomes using a composite of indicators of excessive post-procedure blood loss (post-procedure measured blood loss exceeding 125 mL, uterine massage or compression for at least two minutes, administration of additional uterotonic medication, intrauterine balloon tamponade, uterine re-aspiration, blood transfusion, uterine artery embolization, hospital admission for bleeding, or major surgery). Secondary outcomes included individual indicator occurrences, satisfaction, and side effects. Results From March 3, 2015 to March 31, 2017, we randomized 284 participants (n = 140 methylergonovine, n = 144 placebo), five before we registered the trial with clinicaltrials.gov. Baseline characteristics were similar between groups. The composite outcome occurred in 78 (56%) methylergonovine and 75 (52%) placebo participants (p = 0.5). Methylergonovine recipients required more intrauterine balloon use (n = 20 [14%]) versus placebo (n = 10 [7%]), p = 0.04. We also observed a non-significant trend towards more uterotonic administration (n = 56 [40%] versus n = 43 [30%], p = 0.07) and hospital admissions for bleeding (n = 4 [3%] versus n = 0, p = 0.06) in the methylergonovine group compared to placebo. Conclusion We observed no improvement in the composite outcome for excessive bleeding with prophylactic post-procedure methylergonovine. In addition, individual excessive bleeding outcomes occurred more frequently in the methylergonovine group, potentially indicating harm with its prophylactic use after D&E. Implications When administered prophylactically immediately after Dilation and Evacuation abortion at 20–24 weeks, methylergonovine increases uterine bleeding. Given the lack of data for effectiveness as a prophylactic agent and our findings indicating harm, we do not recommend its use for post-operative prophylaxis.

  • society of family planning clinical recommendations cervical preparation for Dilation and Evacuation at 20 24 weeks gestation
    Contraception, 2020
    Co-Authors: Justin T Diedrich, Eleanor A Drey, Sara J Newmann
    Abstract:

    Abstract Although only 1.3% of abortions in the United States are between 20 and 24 weeks’ gestation, these procedures are associated with elevated risks of morbidity and mortality. Adequate cervical preparation before Dilation and Evacuation (D&E) at 20–24 weeks’ gestation reduces procedural risk. For this gestational range, at least one day of cervical preparation with osmotic dilators is recommended before D&E. The use of overnight osmotic dilators alone is sufficient for most D&Es at 20–24 weeks’ gestation. Dilapan-S® dilators require a shorter time to achieve maximum Dilation, may be more effective than laminaria and may increase the likelihood of success on the first D&E attempt. The use of adjunctive mifepristone administered one-day pre-operatively at the time of osmotic dilator placement, should be considered because evidence demonstrates that it makes D&E subjectively easier at 20–24 weeks without increasing side effects. While older studies suggest that two-days of serial osmotic dilators provide greater Dilation than one day of dilators, adjunctive mifepristone may be comparable to a second day of dilators. Adjunctive misoprostol administered on the day of D&E does not appear to affect initial cervical Dilation and procedure time and compared with mifepristone is associated with more side effects, such as pain and nausea. Using overnight mifepristone and same-day misoprostol without osmotic dilators at 20–24 weeks’ gestation lengthens D&E procedure time and appears to increase immediate complications, at least among less experienced providers. Some evidence shows the feasibility of same-day cervical preparation before D&E at 20–24 weeks using Dilapan-S® with adjunctive misoprostol or serial repeat dosing of misoprostol, but same-day preparation should be limited to providers with significant experience with these regimens. The Society of Family Planning recommends preoperative cervical preparation before D&E at 20–24 weeks’ gestation. Further studies are needed to clarify the best means of preparing the cervix in order to minimize abortion complications and improve outcomes in this gestational range.

  • Estimated versus measured blood loss during Dilation and Evacuation: an observational study
    Contraception, 2018
    Co-Authors: Elissa T. Serapio, Geffan Pearlson, Eleanor A Drey, Jennifer L. Kerns
    Abstract:

    Abstract Objective To compare estimated versus measured blood loss at the time of Dilation and Evacuation (DE we excluded 163 procedures because of failure to measure blood loss or contamination with amniotic fluid. Included and excluded procedures had similar median EBLs. Median EBL differed significantly from MBL for each week gestation from 16 to 24 weeks (p≤.001 for all comparisons); MBL was approximately twice as high as EBL for each gestational week. EBL and MBL increased with increasing gestation, as did the difference between EBL and MBL. Conclusion Providers consistently and significantly underestimate blood loss at the time of D&E. D&E providers may want to consider using a new heuristic for estimating blood loss. Implications Providers significantly underestimate blood loss at the time of D&E. Future research should confirm these findings (particularly at 22–24 weeks gestation), evaluate the efficacy of interventions to improve estimations of blood loss, and determine best practices for decreasing blood loss.

  • Safety of deep sedation without intubation in late second-trimester Dilation and Evacuation
    Obstetrics and gynecology, 2018
    Co-Authors: S. Aksel, Jody Steinauer, Abby Sokoloff, M. Steurer, Lauren Lederle, Eleanor A Drey
    Abstract:

    OBJECTIVE:To estimate the incidence of pulmonary aspiration and other anesthesia-related adverse events in women undergoing Dilation and Evacuation (D&E) under intravenous deep sedation without tracheal intubation in an outpatient setting.METHODS:We reviewed all D&Es done under anesthesiologist-admi

  • Correlation of Prenatal Diagnosis and Pathology Findings Following Dilation and Evacuation for Fetal Anomalies.
    Archives of pathology & laboratory medicine, 2016
    Co-Authors: Carolin A. Boecking, Jennifer L. Kerns, Eleanor A Drey, Walter E. Finkbeiner
    Abstract:

    Context.—Despite increased use of Dilation and Evacuation in the setting of fetuses with developmental anomalies, the pathology examination of fragmented specimens obtained by this technique has be...

Frank A. Chervenak - One of the best experts on this subject based on the ideXlab platform.

  • Dilation and Evacuation at 20 weeks comparison of operative techniques
    American Journal of Obstetrics and Gynecology, 2004
    Co-Authors: Stephen T. Chasen, Robin B. Kalish, Meruka Gupta, William K. Rashbaum, Jane Kaufman, Frank A. Chervenak
    Abstract:

    Abstract Objective The objective of this study is to compare the relative safety of 2 techniques for surgical abortion late in the second trimester. Study design Retrospective review of patients who underwent surgical abortion at ≥20 weeks' gestation at our hospital from June 1996 through June 2003. Records were reviewed to determine whether the technique used was Dilation and Evacuation or intact Dilation and extraction. Subsequent pregnancies at our hospital were identified, and obstetric outcomes were recorded. Categorical data were compared with Fisher exact test and χ 2 analysis. Continuous data were compared with Mann-Whitney U test. Results Three hundred eighty-three patients met inclusion criteria. Intact Dilation and extraction was performed in 120 cases, and Dilation and Evacuation was used in 263. Intact Dilation and extraction was associated with higher parity, later gestational age, and more preoperative cervical Dilation. There was no difference in procedure time or estimated blood loss in the 2 groups. Complications occurred in 19 cases (5.0%), and occurred with similar frequency in the 2 groups. We identified 62 subsequent pregnancies. There were no second-trimester miscarriages. Spontaneous preterm birth occurred in 2 of 17 (11.8%) pregnancies in the intact Dilation and extraction group, compared with 2 of 45 (4.4%) in the Dilation and Evacuation group ( P =.30). Conclusion Outcomes appear similar between patients undergoing Dilation and Evacuation and intact Dilation and extraction after 20 weeks' gestation. Subsequent obstetric outcomes are similar between the 2 groups. The technique for surgical abortion should be determined by the physician on the basis of intraoperative factors.

  • Dilation and Evacuation at ≥20 weeks: comparison of operative techniques
    American journal of obstetrics and gynecology, 2004
    Co-Authors: Stephen T. Chasen, Robin B. Kalish, Meruka Gupta, Jane E Kaufman, William K. Rashbaum, Frank A. Chervenak
    Abstract:

    Abstract Objective The objective of this study is to compare the relative safety of 2 techniques for surgical abortion late in the second trimester. Study design Retrospective review of patients who underwent surgical abortion at ≥20 weeks' gestation at our hospital from June 1996 through June 2003. Records were reviewed to determine whether the technique used was Dilation and Evacuation or intact Dilation and extraction. Subsequent pregnancies at our hospital were identified, and obstetric outcomes were recorded. Categorical data were compared with Fisher exact test and χ 2 analysis. Continuous data were compared with Mann-Whitney U test. Results Three hundred eighty-three patients met inclusion criteria. Intact Dilation and extraction was performed in 120 cases, and Dilation and Evacuation was used in 263. Intact Dilation and extraction was associated with higher parity, later gestational age, and more preoperative cervical Dilation. There was no difference in procedure time or estimated blood loss in the 2 groups. Complications occurred in 19 cases (5.0%), and occurred with similar frequency in the 2 groups. We identified 62 subsequent pregnancies. There were no second-trimester miscarriages. Spontaneous preterm birth occurred in 2 of 17 (11.8%) pregnancies in the intact Dilation and extraction group, compared with 2 of 45 (4.4%) in the Dilation and Evacuation group ( P =.30). Conclusion Outcomes appear similar between patients undergoing Dilation and Evacuation and intact Dilation and extraction after 20 weeks' gestation. Subsequent obstetric outcomes are similar between the 2 groups. The technique for surgical abortion should be determined by the physician on the basis of intraoperative factors.

  • Impact of midtrimester Dilation and Evacuation on subsequent pregnancy outcome.
    American journal of obstetrics and gynecology, 2002
    Co-Authors: Robin B. Kalish, Stephen T. Chasen, William K. Rashbaum, Laura B. Rosenzweig, Frank A. Chervenak
    Abstract:

    Abstract Objective: This study was undertaken to evaluate the impact of second-trimester Dilation and Evacuation (DE187:882-5.)

Samar Nahas - One of the best experts on this subject based on the ideXlab platform.

  • total laparoscopic hysterectomy in combination with Dilation and Evacuation of an 18 week sized uterus with gestational trophoblastic neoplasia a novel treatment approach
    American Journal of Obstetrics and Gynecology, 2021
    Co-Authors: Megha Patel, Mallory A. Stuparich, Samar Nahas
    Abstract:

    Gestational trophoblastic disease is a spectrum that includes complete and partial hydatidiform moles, invasive mole, choriocarcinoma, and placental site trophoblastic tumor. Although most cases of gestational trophoblastic neoplasia occur after a molar pregnancy, it can develop after any pregnancy. Suction curettage remains the standard first-line management in a molar pregnancy in patients desiring fertility. However, hysterectomy is a reasonable option in patients that do not desire to preserve fertility. Hysterectomy for gestational trophoblastic neoplasia can be difficult because of the enlarged uterus and prominent uterine vasculature. Traditionally, hysterectomy for gestational trophoblastic neoplasia is usually performed via laparotomy. In this article and accompanying video, we describe and illustrate a minimally invasive technique that demonstrates a safe and feasible laparoscopic removal of an enlarged uterus and illustrates alternative extraction techniques to avoid laparotomy in hysterectomy for gestational trophoblastic disease. In this case, a combination of laparoscopic transection of the vascular pedicles followed by Dilation and Evacuation was used before colpotomy. The addition of Dilation and Evacuation allowed us to reduce the overall size of the uterus and remove it intact through the vagina with minimal bleeding, avoiding unnecessary laparotomy. This allowed the patient to have an improved postsurgical recovery experience with minimal blood loss compared with standard laparotomy for gestational trophoblastic neoplasia.

  • Total laparoscopic hysterectomy in combination with Dilation and Evacuation of an 18-week–sized uterus with gestational trophoblastic neoplasia: a novel treatment approach
    American journal of obstetrics and gynecology, 2020
    Co-Authors: Megha Patel, Mallory A. Stuparich, Samar Nahas
    Abstract:

    Gestational trophoblastic disease is a spectrum that includes complete and partial hydatidiform moles, invasive mole, choriocarcinoma, and placental site trophoblastic tumor. Although most cases of gestational trophoblastic neoplasia occur after a molar pregnancy, it can develop after any pregnancy. Suction curettage remains the standard first-line management in a molar pregnancy in patients desiring fertility. However, hysterectomy is a reasonable option in patients that do not desire to preserve fertility. Hysterectomy for gestational trophoblastic neoplasia can be difficult because of the enlarged uterus and prominent uterine vasculature. Traditionally, hysterectomy for gestational trophoblastic neoplasia is usually performed via laparotomy. In this article and accompanying video, we describe and illustrate a minimally invasive technique that demonstrates a safe and feasible laparoscopic removal of an enlarged uterus and illustrates alternative extraction techniques to avoid laparotomy in hysterectomy for gestational trophoblastic disease. In this case, a combination of laparoscopic transection of the vascular pedicles followed by Dilation and Evacuation was used before colpotomy. The addition of Dilation and Evacuation allowed us to reduce the overall size of the uterus and remove it intact through the vagina with minimal bleeding, avoiding unnecessary laparotomy. This allowed the patient to have an improved postsurgical recovery experience with minimal blood loss compared with standard laparotomy for gestational trophoblastic neoplasia.

Jody Steinauer - One of the best experts on this subject based on the ideXlab platform.

  • disseminated intravascular coagulation and hemorrhage after Dilation and Evacuation abortion for fetal death
    Obstetrics & Gynecology, 2019
    Co-Authors: Jennifer L. Kerns, Abby Sokoloff, S. Aksel, Lauren Lederle, Jody Steinauer
    Abstract:

    OBJECTIVE To examine the association between fetal death and risk of hemorrhage and disseminated intravascular coagulation (DIC) among women undergoing Dilation and Evacuation (D&E) procedures. METHODS We conducted a retrospective cohort study of all D&Es at one academic abortion clinic in San Francisco between 2009 and 2013. We abstracted data on fetal death status, demographic characteristics, and complications including hemorrhage and DIC. We examined the risk of hemorrhage and DIC among women with fetal death compared with those without. We conducted unadjusted and adjusted analyses for the outcomes of hemorrhage, DIC, and any complication. RESULTS Among 92 cases of D&E for fetal death and 4,428 cases of D&E for other reasons, hemorrhage occurred in 10% and 7%, respectively (P=.28), and DIC occurred in 2.0% and 0.2% of the fetal death and nonfetal death cohorts (P<.001). In adjusted analysis, fetal death was associated with 2.9 times higher odds of hemorrhage (95% CI 1.4-6.0). In an unadjusted analysis, fetal death was associated with 12.3 times higher odds of DIC (95% CI 2.6-58.6) and 3.0 times higher odds of any complication (95% CI 1.6-5.9). CONCLUSION Women undergoing D&E for fetal death are far more likely to experience DIC and hemorrhage than are women without fetal death, yet the absolute risk is low (2%). Although D&E providers should be prepared for DIC and hemorrhage, we do not recommend any specific preoperative preparation because the vast majority of D&E abortions for fetal death are uncomplicated.

  • Disseminated Intravascular Coagulation and Hemorrhage After Dilation and Evacuation Abortion for Fetal Death.
    Obstetrics and gynecology, 2019
    Co-Authors: Jennifer L. Kerns, Abby Sokoloff, S. Aksel, Lauren Lederle, Jody Steinauer
    Abstract:

    OBJECTIVE To examine the association between fetal death and risk of hemorrhage and disseminated intravascular coagulation (DIC) among women undergoing Dilation and Evacuation (D&E) procedures. METHODS We conducted a retrospective cohort study of all D&Es at one academic abortion clinic in San Francisco between 2009 and 2013. We abstracted data on fetal death status, demographic characteristics, and complications including hemorrhage and DIC. We examined the risk of hemorrhage and DIC among women with fetal death compared with those without. We conducted unadjusted and adjusted analyses for the outcomes of hemorrhage, DIC, and any complication. RESULTS Among 92 cases of D&E for fetal death and 4,428 cases of D&E for other reasons, hemorrhage occurred in 10% and 7%, respectively (P=.28), and DIC occurred in 2.0% and 0.2% of the fetal death and nonfetal death cohorts (P

  • Safety of deep sedation without intubation in late second-trimester Dilation and Evacuation
    Obstetrics and gynecology, 2018
    Co-Authors: S. Aksel, Jody Steinauer, Abby Sokoloff, M. Steurer, Lauren Lederle, Eleanor A Drey
    Abstract:

    OBJECTIVE:To estimate the incidence of pulmonary aspiration and other anesthesia-related adverse events in women undergoing Dilation and Evacuation (D&E) under intravenous deep sedation without tracheal intubation in an outpatient setting.METHODS:We reviewed all D&Es done under anesthesiologist-admi

  • obesity as a risk factor for complications after second trimester abortion by Dilation and Evacuation
    Obstetrics & Gynecology, 2015
    Co-Authors: Lauren Lederle, Jody Steinauer, Eleanor A Drey, Anne Montgomery, Sarp Aksel, Jennifer L. Kerns
    Abstract:

    OBJECTIVE:To evaluate the association between obesity (body mass index [BMI] 30 or higher) and Dilation and Evacuation (D&E) complications.METHODS:We conducted a retrospective cohort study of women who underwent D&E abortion from February 2009 to April 2013 at a hospital-based abortion practice in C

  • risk factors for complication after second trimester Dilation and Evacuation
    Contraception, 2014
    Co-Authors: Lauren Lederle, Jody Steinauer, Eleanor A Drey, Anne Montgomery, Sarp Aksel, Jennifer L. Kerns
    Abstract:

    • Many abortion centers limit care to non-obese women, which leads to delayed care and therefore increased risk of complications for obese women [8]. • The relationship of obesity with complications of second trimester abortion, and the magnitude of the association remain unclear [6,7]. Abortions by Gestational Age Abortions-related Mortality by Gestational Age Risk Factors for Complication After Second Trimester Dilation & Evacuation Lauren Lederle, BA1, Jody Steinauer, MD, MAS1, Anne Montgomery, BA1, Sarp Aksel, BA2, Eleanor Drey, MD, EdM1, Jennifer L. Kerns, MD, MPH1,