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Second Trimester

Second Trimester- 13 – 24 Weeks

Dilation and Evacuation (D&E)

Performed between 13-26 weeks
Similar to a D&C, however the fetal parts are too large to pass through the canulla. This procedure is accomplished by inserting laminaria (osmotic dilators) a day or two before the abortion. After opening the cervix, the abortion provider inserts a cannula and begins removing tissue away from the uterine lining. Then removes the remaining tissue with a curette, forceps or both. Suction curettage may be used as a final step to ensure that no fetal parts remain. This type of abortion is performed under sedation combined with local anesthesia (twilight).
Side effects include nausea, bleeding, cramping (up to 2 weeks after the procedure). More severe side effects include damage to the uterine lining or cervix, perforation of the uterus, infection and blood clots.

Saline Amniocentesis (Salting Out or Salt Poisoning)

Performed after the 16th week
A needle is inserted through the mother’s abdomen, amniotic fluid is withdrawn and replaced with a concentrated salt solution surrounding the fetus. The fetus inhales and swallows the solution, then uterine contractions take place and the fetus is expelled. This may take up to 72 hours.

Induction Abortion

Performed in the 2nd and 3rd Trimesters
A surgical procedure (rarely performed) in which salt water, urea or potassium chloride is injected into the amniotic sac. Laminaria is sometimes inserted to assist with dilation. Prostaglandins are inserted into the vagina and pitocin is injected intravenously. Uterine contractions begin after which the fetus is expelled. This procedure is normally only performed when a medical problem problem or illness is present.
Side effects include nausea, bleeding, cramping (up to 2 weeks after the procedure). More severe side effects include damage to the uterine lining or cervix, perforation of the uterus, infection and blood clots.

Intercardiac Injection

Performed at 16 weeks and above
Ultrasound is used to pinpoint the location of the fetal heart. Fluid from a needle is injected into the heart, causing immediate cardiac arrest which terminates the pregnancy. Used commonly in ‘pregnancy reduction’ abortions when multiple fetuses are present and some are aborted to give others a better chance of survival, or they are taken because of defects or gender.

Prostaglandin’s

Used after 3-4 months of gestation
Prostaglandin is a synthetic, hormonal drug which is injected into the amniotic sac, causing uterine contractions resulting in expulsion of the fetus. Often salt or another toxin is first injected to ensure that the fetus will be aborted, since some have survived this procedure. In addition to risks of retained placenta, cervical trauma, infection, hemorrhage, hypothermia, bronchoconstriction, tachycardia, more serious side effects and complications from the use of artificial prostaglandin’s, including cardiac arrest and rupture of the uterus. Death is not an unheard of complication. This method is falling out of favor and being replaced by other methods.