Efficacy

Safety

Complications

Dilatation and evacuation

99% successful abortion rate [32]

Complications are less frequent in earlier gestation. The preferred technique of cervical dilatation is to use multiple osmotic dilators.

Cervical laceration, hemorrhage, uterine perforation, infection, incomplete abortion requiring repeat evacuation (similar to first trimester surgical abortion)

Intrauterine instillation of abortifacients

93% successful abortion rate [33]

The location of the needle after insertion needs to be confirmed by withdrawing a small amount of amniotic fluid to prevent intravascular or intramyometrial infusion.

Transient fetal survival, gastrointestinal side effects, hypernatremia, fluid overload

Administration of systemic abortifacients

97% successful abortion rate [28]

Combined mifepristone and misoprostol regimen has been shown to shorten the induction to delivery time and decrease procedure-related pain compared to prostaglandin only regimens.

Fever, shivering, gastrointestinal discomfort, retained products of conception requiring surgical evacuation