Choice of anesthetic technique for dilation and curettage for indication of pregnancy loss

Abstract

We hypothesized that patients at our hospital who received general anesthesia as the initial anesthetic technique for dilation and curettage for loss of pregnancy during the first or second trimesters would have a higher estimated blood loss compared to patients who had sedation. We searched our electronic medical record system for patients who had a dilation and curettage for the indication of loss of pregnancy during the first or second trimesters from July 1, 2018, to June 30, 2021. A total of 165 (72%) and 64 (28%) patients had general anesthesia and sedation, respectively, as the initial anesthetic technique. Patients who had general anesthesia and sedation had estimated blood loss interquartile ranges of 50 to 500 mL and 30 to 100 mL, respectively (P < 0.01). A multivariate model that controlled for gestational age and location of procedure found that the odds ratio of patients receiving sedation for dilation and curettage in the labor and delivery suite was 7.24 (95% confidence interval 2.92, 17.94; P < 0.01) compared to the main operating room. Dilation and curettage that used sedation was associated with a lower estimated blood loss and was more likely to be performed in the labor and delivery suite.

Keywords:

• Abortion
• spontaneous
• anesthesia
• general
• deep sedation
• dilatation and curettage