Abortion in the second trimester - from 13 to 24 weeks - is generally performed using a procedure

called Dilation & Evacuation (D&E). The D&E procedure is different from a 1st trimester abortion in a
number of ways.
Dilation and evacuation (D&E) is done in the second 12 weeks (second trimester) of pregnancy. It
usually includes a combination of vacuum aspiration, dilation and curettage (D&C), and the use of
surgical instruments (such as forceps).

Thrombophilia or hypercoagulability is the propensity to develop thrombosis (blood clots) due to an

abnormality in the system of coagulation.[1][2] Hereditary defects in one or more of the clotting factors
can cause the formation of potentially dangerous blood clots (thrombosis).
The most common symptoms of thrombophilia are deep vein thrombosis (DVT) and pulmonary
embolism (PE), two conditions referred to together as venous thromboembolism (VTE). DVT usually
occurs in the legs, and is characterized by pain, swelling and redness of the limb. It may lead to long-
term swelling and heaviness in a proportion of cases due to damage to valves in the veins. The clot may
also break off and migrate (embolism) to the lungs. Depending on the size and the location of the
embolus this may lead to sudden-onset shortness of breath, chest pain, palpitations and may be
complicated by collapse, shock and cardiac arrest.[2] Venous thrombosis may also occur in more
unusual places: in the brain (cerebral venous sinus thrombosis), liver (portal vein thrombosis and
hepatic vein thrombosis), mesenteric vein, kidney (renal vein thrombosis) and possibly the veins of the
arms.[2] Whether thrombophilia also increases the risk of arterial thrombosis is less well established;
myocardial infarction (heart attack) and stroke are caused by arterial thrombosis.[2]
Thrombophilia has been linked to both recurrent miscarriage and possibly various complications of
pregnancy such as intrauterine growth restriction, stillbirth, severe pre-eclampsia and abruptio
placentae.[2]
Causes of thrombophilia can be acquired or congenital.
• Acquired refers to transient or acquired conditions that increase the tendency to clot. This
might include antiphospholipid antibodies or a temporary hypercoagulable state such as
pregnancy. Also, advanced carcinomas of the pancreas or lung may produce Trousseau
syndrome, which creates a hypercoagulable state.
• Congenital refers to hereditary conditions that increase the tendency to clot. These include
Factor V Leiden (see below); prothrombin G20210A; protein C, protein S and antithrombin
deficiencies.
An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any
ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. An ovarian cyst can
be as small as a pea, or larger than an orange.
Most ovarian cysts are functional in nature, and harmless (benign).[1] In the US, ovarian cysts are
found in nearly all premenopausal women, and in up to 14.8% of postmenopausal women.[citation
needed]
Ovarian cysts affect women of all ages. They occur most often, however, during a woman's
childbearing years.
Some ovarian cysts cause problems, such as bleeding and pain. Surgery may be required to remove
cysts larger than 5 centimeters in diameter.
• Dull aching, or severe, sudden, and sharp pain or discomfort in the lower abdomen (one or both
sides), pelvis, vagina, lower back, or thighs; pain may be constant or intermittent—this is the
most common symptom
• Fullness, heaviness, pressure, swelling, or bloating in the abdomen
• Breast tenderness
• Pain during or shortly after beginning or end of menstrual period.
• Irregular periods, or abnormal uterine bleeding or spotting
• Change in frequency or ease of urination (such as inability to fully empty the bladder), or
difficulty with bowel movements due to pressure on adjacent pelvic anatomy
• Weight gain
• Nausea or vomiting
• Fatigue
• Infertility
• Increased level of hair growth
• Increased facial hair or body hair
• Headaches
• Strange pains in ribs, which feel muscular
• Bloating
• Strange nodules that feel like bruises under the layer of skin