Publication:

Incidence and etiological profile of second trimester abortion: a prospective observational study

Background Second trimester abortion, occurring between 14 and 24 weeks of gestation, is associated with higher maternal morbidity compared to first trimester termination. Despite its relatively lower incidence, it contributes disproportionately to abortion-related complications. Understanding the incidence and etiological factors is essential for improving preventive and clinical strategies. The aim was to determine the incidence and most common causes of second trimester abortion in a tertiary care center.

Methods This prospective observational study was conducted in the Department of Obstetrics and Gynaecology at Government Raja Mirasudhar Hospital, Thanjavur Medical College, over a period of one year. A total of 315 women with second trimester abortion (14–24 weeks gestation) were included. Data regarding sociodemographic characteristics, obstetric profile, type of abortion (spontaneous or induced), and etiological factors were collected and analyzed. Descriptive statistics were used, and results were expressed as mean±standard deviation, frequencies, and percentages. Appropriate statistical tests were applied, with p<0.05 considered significant.

Results The mean age of participants was 24.21±5.13 years. Induced abortions constituted 82.5% of cases, while spontaneous abortions accounted for 17.5%. The majority of abortions occurred between 17–19 weeks of gestation (45.7%). Among spontaneous abortions, unexplained causes were most common (52%), followed by cervical incompetence (13%) and uterine anomalies (11%). A statistically significant association was observed between age and type of abortion (p<0.05).

Conclusion Second trimester abortion is predominantly induced, reflecting increasing reliance on medical termination for late-detected pregnancies and fetal anomalies. Among spontaneous abortions, a significant proportion remains unexplained, highlighting the need for improved diagnostic evaluation. Early identification of preventable causes such as cervical incompetence and enhanced antenatal care was essential to reduce maternal morbidity.