A late-term abortion often refers to an induced abortion procedure that occurs after the 20th week of gestation. However, the exact point when a pregnancy becomes late-term is not clearly defined. Some sources define an abortion after 14 weeks as “late”.
Dilation and evacuation (also sometimes called dilation and extraction) literally refers to the dilation of the cervix and surgical evacuation of the contents of the uterus. It is a method of abortion as well as a therapeutic procedure used after miscarriage to prevent infection by ensuring that the uterus is fully evacuated.
In various health care centers it may be called by different names:
D&E (Dilation and evacuation)
ERPOC (Evacuation of Retained Products of Conception)
TOP or STOP ((Surgical) Termination Of Pregnancy)
D&E normally refers to a specific second trimester procedure.
In many European countries (Switzerland, Germany, Austria and mostly France) from the 14th week of pregnancy a miscarriage is initiated medically and not with D&E!
However, some sources use the term D&E to refer more generally to any procedure that involves the processes of dilation and evacuation, which includes the first trimester procedures of manual and electric vacuum aspiration.
The first step in a D&E is to dilate the cervix. This is often begun about a day before the surgical procedure, and often involves the insertion of multiple laminaria sticks into the cervix. Enlarging the opening of the cervix enables surgical instruments such as a curette or forceps to be inserted into the uterus.
The second step is to remove the fetus. Either a local anesthetic or general anesthesia is given to the woman. A cannula is passed into the uterus. The cannula is attached by tubing to a bottle and a pump that provides a vacuum to remove tissue from the uterus. Forceps are inserted into the uterus through the vagina and used to extract any remaining tissue. This is more likely in pregnancies of 16 weeks or more. A curette is used to scrape the lining of the uterus and remove tissue in the uterus. Lastly, the vacuum is used to ensure no fetal tissue remains in the uterus (such tissue can cause serious infections in the woman). The pieces are also examined to ensure that the entire fetus was removed.