Adi Weintraub

Objective: To compare perinatal outcomes in subsequent pregnancies following second-trimester abortions, stratified by the method of abortion. Methods: A historic cohort study was conducted in a single tertiary hospital, including women who had second-trimester abortions between 12⁺⁰ and 24⁺⁰ weeks and subsequent documented pregnancies within 3–60 months. Data were collected from hospitalization and perinatal databases. Composite outcome variables were constructed, and multivariable logistic regression was used to analyze associations, adjusting for confounders. Results: Among 771 women meeting the inclusion criteria, 83% had surgical abortions and 17% had medical abortions. Medical abortion was associated with a higher incidence of placenta-associated pregnancy complications compared with surgical abortion. No significant differences were found in other perinatal outcomes. Conclusion: The study highlights the potential influence of the abortion method on subsequent pregnancy outcomes, particularly regarding placenta-associated complications. This underscores the importance of considering the method of second-trimester abortion in counseling women regarding potential risks to subsequent pregnancies. Adverse outcomes in subsequent pregnancies following second-trimester abortion were associated with the medical method of abortion, warranting further research and careful counseling in clinical practice.