Miscarriages, 2nd trimester 1998-2010 (Updated May 2010)
2nd trimester spontaneous abortions and missed abortions 1998-2010

Resopnsible Charlotte Skovlund and Øjvind Lidegaard

1.0  Miscarriages second trimester 1998-2010. N = 21,099

Same in per cent

Comments: The number of 2nd trimester miscarriages has decreased with 30% from 1998 to 2010.
It is primarily spontaneous abortions which have decreased (with 47%). During the same decade,
missed abortions have increased their share of miscarriages from 51% in 1998 to 63% in 2010.

1.2  Spontaneous abortion 2. trimester 1998-2010. N = 8.800

Comments: The overall 47% reduction in 2nd trimester spontaneous abortion has been most
pronounced for the late 2nd trimister abortions, but is also stricking for the early 2nd trimester
abortions.

1.3  Surgical evacuation rate (%) after early and late 2. trimester spontaneous
       abortion. N early: 4,183, N late: 1,254.

1.4  Surgical evacuation rate (%) after 2. trimester spontaneous abortion with a
       gestational age of 16 weeks or longer. N = 1,781, n = 1,066
       Evacuation rate in per cent at top of each column, absolute number of evacuations inside below. 

Comments: For the early 2nd trimester abortions, the evacuation rate has declined significantly
from 87% in 1998 to 56% in 2007, however no reduction has been seen since 2004.
The the late 2nd trimester spontaneous abortions, the evacuation rate has been more stable around
60%. In contrast to previously, the evacuation rate today is higher for the late than for the early spon-
taneous 2nd trimester spontaneous abortions.

1.5  Evacuation rate (%) after 2nd trimester spontaneous abortion at different
       departments in 2010. N = 498 (abortions), n = 210 (evacuations).

Comments: Despite small figures at some departments, the practice at each department is surprisingly
stable over years, and range now from 29% in Herlev and Skejby to 60% in Esbjerg and Silkeborg.
This difference is probably primarily due to different professional views on this practice, rather than to differences
in clinical  appearance of the women with spontaneous abortions. The wide span suggest that we could abstain from
many of these evacuations. If all departments had a practice as in Herlev, 69 of the 210 conducted
evacuations or 33% could have been avoided.

 1.6  Evacuation rate (%) after 2nd trimester missed abortions in Denmark 1998-2010.
        N = 12,299, n = 5,783. Absolute number of evacuated in italics in bollom of colums.

Comments: The evacuation rate reached a minimun of 34% in 2010. The evacuations include primary
evacuations as well as evacuations after medical treatment.

1.7   Evacuation rate (%) after 2nd trimester missed abortion at different departments
        in 2010. N = 828, n = 283. Absolute number of evacuations indicated in bottom of each column.

Comments: The evacuation rate after 2nd trimester missed abortion ranges from 13% in Herning to
53% at RH. It is not possible to specify the best practice, but the variation again probably
reflects differences in clinical opinion rather than differences in patient characteristics.
There is only a weak association between the evacuation rate after spontaneous abortion and the
evacuation rate after missed abortion at different departments.