IUFD and bleeding outcomes

While dilation and evacuation (D&E) is safe and effective for second trimester abortion, evidence suggests higher bleeding risk with intrauterine fetal demise (IUFD). We examined associations between IUFD duration and bleeding outcomes. IUFD duration was calculated by subtracting gestational age by fetal biometry from gestational age by dating. Of 189 patients, those >28 days of IUFD duration were 2.45 times more likely to develop coagulopathy (95% CI:0.2-27.8) and 2.45 times more likely to develop hemorrhage (95% CI:0.2-27.8) compared to patients 0-14 days of IUFD duration. This suggests that prolonged time to D&E may contribute to higher risk of bleeding outcomes.