(563) Maternal and neonatal outcomes following a second trimester dilation and curettage

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: To evaluate the maternal and neonatal outcomes of pregnancies after a second-trimester dilation and curettage (D&C) following a spontaneous miscarriage.

Study Design: A retrospective analysis of prospectively collected data of women who conceived ≤ 6 months following a spontaneous miscarriage and subsequently delivered in a single tertiary medical center between 2016 and 2021. The maternal and neonatal outcomes of women with second trimester (15-21 weeks) who eventualy underwent curettage were compared to those who had the first trimester (< 14 weeks) D&C. The primary outcome of this study was the rate of preterm birth (< 37 weeks). Secondary outcomes were adverse maternal and neonatal outcomes. Univariate analysis was followed by multiple logistic regression models; adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated.

Results: During the study period, 1365 women met the inclusion criteria; of those, 272 (19.9%) women gave birth following second trimester D&C and 1093 (80.1%) following first trimester D&C. Maternal demographic and obstetric characteristics including maternal age, gravidity, parity, number of previous miscarriages, previous cesarean deliveries and obesity rates were similar between the groups. We found no differences between the study groups in any maternal or neonatal parameter examined including preterm birth (5.1% vs. 5.3%, p=0.91), fertility treatments, hypertension disorders of pregnancy, placental complications, mode of delivery and neonatal birth weights (Table 1). This was confirmed on a multivariate analysis as well [aOR 1.02 (0.53–1.94), p = 0.96] for preterm birth (Table 2).

Conclusion:

History of a second trimester spontaneous miscarriage treated by curretage confers no additional risk than first trimester to pregnancies conceived within six months of the index miscarriage. Further propective studies to strengthen these findings are needed.

Primary Author(s)

Tal Margaliot Kalifa, MD
Shaare Zedek
Jerusalem, Yerushalayim, Israel

Coauthor(s)

HS
Hen Sela, MD
Shaare Zedek Medical Center
Jerusalem, Israel
SG
Sorina Granovsky Grisaru, MD,PhD
head of Obstetrics & Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel
Jerusalem, Yerushalayim, Israel

Presenting Author(s)

Misgav Rottenstreich, MBA, MD (he/him/his)
Clinical Fellow
McMaster University
Hamilton, Ontario, Canada