Dark Allison C, Miller Leslie, Kothenbeutel Robert L, Mandel Lynn
Feminist Women's Health Center, Renton, Washington, USA.
J Reprod Med. 2002 Mar;47(3):226-30.
To examine the relationship between body mass index (BMI) and dilation and evacuation (D&E) procedure characteristics.
Data were collected on all women seeking elective surgical second-trimester abortion during a six-week period at a free-standing abortion clinic. Information gathered included age, pregnancy history, height, weight, intravenous sedation, time for procedure, estimated blood loss, use of special instruments, amount of manual dilation needed and gestational age by ultrasound and pathology. Difficulty was rated by a single physician immediately following the surgery using a 10-cm line later converted to a visual analog score.
One hundred ninety-eight women underwent D&E during the study period. Data were complete for 163 (82%). Subject demographics and procedure outcomes were analyzed with BMI as a variable. A trend was observed for increased procedure difficulty, time for procedure, blood loss and complications as BMI increased. On average, the procedure for a subject with BMI > or = 30 took 20% longer and was rated as 40% more difficult to perform as compared to procedures on women with BMI < 30.
We identified a trend with BMI score and some D&E procedure characteristics, but the power of the study was limited. Abortion providers should be aware that obesity may necessitate the availability of special instruments and/or an alterations in surgical technique.
研究体重指数（BMI）与扩张和刮宫术（D&E）手术特征之间的关系。
收集了一家独立堕胎诊所六周内所有寻求选择性中期妊娠手术流产的女性的数据。收集的信息包括年龄、孕产史、身高、体重、静脉镇静、手术时间、估计失血量、特殊器械的使用、所需手动扩张量以及超声和病理检查确定的孕周。手术结束后，由一名医生使用一条10厘米长的线对手术难度进行评分，随后转换为视觉模拟评分。
在研究期间，198名女性接受了扩张和刮宫术。163名（82%）的数据完整。以BMI为变量对受试者人口统计学特征和手术结果进行分析。随着BMI的增加，观察到手术难度、手术时间、失血量和并发症呈上升趋势。平均而言，与BMI<30的女性相比，BMI≥30的受试者的手术时间长20%，手术难度高40%。
我们发现BMI评分与一些扩张和刮宫术手术特征之间存在一种趋势，但该研究的效力有限。堕胎提供者应意识到，肥胖可能需要配备特殊器械和/或改变手术技术。
