Termination of multiple pregnancy at 18-24 weeks' gestation by Laminaria dilatation and evacuation.

Objective: To compare outcome in women undergoing termination of multiple pregnancy as compared with singleton pregnancy at 18-24 weeks' gestation by Laminaria dilatation and evacuation.

Study Design: The medical records of 372 consecutive women undergoing does not increase pregnancy termination by Laminaria dilatation and evacuation at 18-24 weeks' gestation between January 1997 and December 2001 were reviewed and divided into a group with multiple pregnancies (38 cases) and a group with singleton pregnancies (334 cases). The 2 groups were then compared for differences in patient characteristics, indications for pregnancy termination and operative outcome. Statistical methods included Student's t and chi2 test.

Results: Patients with multiple pregnancies were significantly older (P < .01), and a greater percentage of them were married (P < .001). The percentage of pregnancies following infertility treatment was also significantly higher in the group with multiple pregnancies (P < .0001). Furthermore, significantly more patients with multiple than singleton pregnancy underwent pregnancy termination due to preterm premature rupture of membranes (42.1% vs. 0.3%) (P < .00001), while significantly more singleton pregnancies were terminated due to structural and chromosomal fetal malformations (34.5% vs 10.6%) (P = .03). Operative outcome between the study groups differed mainly regarding blood transfusion; it was significantly greater in the group of patients undergoing multiple, as compared with singleton, termination (7.9% vs. 0.3%) (P < .00001). The group with multiple pregnancy had a longer hospital stay (1.7 +/- 0.9 vs. 1.2 +/- 0.5 days) (P < .001).

Conclusion: Termination of multiple pregnancies at 18-24 weeks' by dilatation and evacuation appears safe when performed by skilled surgeons. There is an increased need for blood transfusion.