D & X procedures are performed during the third trimester of pregnancy if:
Many of the fetuses which fall into this category have developed hydrocephalus. Approximately 1 in 2,000 fetuses develop hydrocephalus while in the womb; this is about 5,000 a year in the United States. The defect is not usually discovered until late in the second trimester of pregnancy.
If a fetus develops hydrocephalus, the head may expand to a size of up to 250% of the radius of an adult skull, making it impossible for it to pass through the birth canal[?]. In such a case, the physician may elect to perform a D & X procedure by draining off the fluid from the brain area, collapsing the fetal skull and withdrawing the dead fetus. Allowing a woman to continue in labor with a severely hydrocephalic fetus is not an option; attempted birth would kill her.
In the 2 to 3 day procedure, the cervix is dilated. The fetus is delivered feet-first. The surgeon inserts a sharp object into the back of the fetus' head, and inserts a vacuum tube through which the brains and its fluids are extracted. The head of the fetus contracts at this point and allows the fetus to be more easily removed from the womb. The fetus can then be removed with less damage to the woman. The technique was pioneered by Dr. Martin Haskell[?] in 1992.
D & X procedures are not performed during the first trimester, because there are better ways to perform abortions. There is no need to follow such a procedure because the fetus' head is quite small at this stage of gestation and can be quite easily removed from the woman's uterus.
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