Early and late complications following surgical abortion

Abstract

PIP: A review of the literature concerning early and late complications associated with induced abortion is presented. In the U.S. and some other countries, the mortality rate due to abortion has decreased over the past 5-10 years. This decrease is due in large part to the increased experience of those who perform abortions and the increased incidence of the use of vacuum aspiration to perform first trimester abortion, which requires no general anesthesia and is associated with fewer complications. In the U.S., anesthesia complications are responsible for about 15% of the abortion mortality rate. The frequency of complications is directly related to the type of abortion procedure used and the age of the pregnancy at the time of abortion. Menstrual regulation has the lowest complication rate, while any operation involving laparotomy or vaginal intervention has a high mortality and morbidity rate. Early complications of vacuum aspiration or curettage include anesthesia complication, bleeding, cervical laceration or injury, infection, uterine perforation, and failure to remove fetal matter completely. Late complications of abortion which are definitely related to the operation are erythroblastosis and laceration of the cervix. Ectopic pregnancy, a complication of later pregnancies, cannot be related directly to a previously performed abortion. The Hegar method is no longer preferred for dilatation. Rh-negative women should receive a 200 mcg dosage of anti-D serum after an abortion. Although the simultaneous performance of abortion and sterilization can have positive aspects, e.g. less patient stress, less cost, the need for only 1 anesthesia, this can lead to a multiplication of complications or the situation in which a woman feels herself pressured into undergoing sterilization.