Abortion in women with severe preeclampsia and eclampsia prior to 24 weeks gestation.

OBJECTIVE: Due to poor prognosis, obstetric care providers often recommend abortion for women diagnosed with severe preeclampsia prior to fetal viability. However, there is limited available evidence to guide the counseling regarding risks. STUDY DESIGN: This study is a retrospective case series that describes outcomes of all women who underwent abortions with the diagnosis of severe preeclampsia or eclampsia prior to 24 weeks gestation. RESULTS: This case series describes 11 women who underwent abortion prior to 24 weeks gestation due to severe preeclampsia or eclampsia, 9 by dilation and evacuation and 2 by labor induction. The majority of women underwent dilation and evacuation and no women undergoing either induction of labor or dilation and evacuation had severe complications directly related to the abortion. CONCLUSIONS: This case series provides information on the safety of abortion procedures in women with severe preeclampsia and eclampsia syndrome.

Medical abortion in women with large uterine fibroids: a case series.

Women with fibroid uteri seeking surgical abortion often represent a unique challenge. When the uterine cavity is significantly enlarged or distorted making surgical evacuation difficult or impossible, we offer medical abortion using mifepristone followed by misoprostol beyond the standard 63- to 70-day gestational age cutoff that is typically recommended. This case series describes our regimen and outcomes for 6 patients from 10 to 13 weeks gestation underdoing outpatient medical abortion and 6 patients from 14 to 20 weeks gestation undergoing inpatient medical abortion. Three patients required evacuation for retained products and all others had successful medical abortions without complications.