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Views and attitudes. towards termination of pregnancy have shown
con siderable evolution over the past few decades. Along with these
changes has come a growing concern to adopt means and methods which
could make termination easier, safer and more effective. In this
evolution, termination in the second trimester in par icular is
notable as being responsible for a dis proportionate share ofthe
complications and adverse experiences associated with pregnancy
termination. Although the almost universal shift towards earlier
abortion has reduced the number of second trimester procedures as a
percentage of the whole, the problems of interrupting pregnancy in
the second trimester remain conspicuous. Delay in either seeking or
obtaining abortion is still, in many parts of the world, all too
frequent. AdditiDnally, recent developments in the prenatal
diagnosis of fetal malformations, alphafeto protein screening
programmes and changes in the pattern of and approaches to
intrauterine fetal death now also place greater emphasis on the
need for adequate methods of interrupting pregnancy in the second
trimester. Unlike the first trimester in which vacuum aspiration is
universally con sidered to be the method of choice, in the second
trimester of pregnancy the clinician is faced with alternatives;
one method may be more appropriate than another in a particular
circumstance and no single method is unequivocall accepted as best.
Neither do second trimester terminations form a neatly defined
single category."
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