Abstract
BackgroundEvery year around 50 million unintended pregnancies worldwide are terminated by induced abortion. Even in countries, where it is legalized and performed in a safe environment, abortion carries some risk of complications for women. Findings of researchers on the factors that influence the sequelae of abortion are controversial and inconsistent. This study evaluates the effects of gestational age and the method of surgical abortion (i.e., dilatation and curettage and vacuum aspiration) on the most common abortion complications: postabortion hemorrhage and fever.MethodsWe performed a secondary analysis of the data from the population-based Georgian Reproductive Health Survey 2010. Information on 1974 surgical abortions performed >30 days prior to the survey interview were analyzed during the study. Logistic regression statistical analysis was applied to compare the abortion sequelae that followed vacuum aspiration and dilatation and curettage at different gestational ages (<10 weeks and ≥10 weeks). We examined two major early abortion-related complications: postabortion hemorrhage and febrile morbidity (fever ≥38 °C).ResultsPostabortion hemorrhage was reported in 43 cases (1.9%), and febrile morbidity occurred in 44 cases (2%) among all of the surgical abortions. The abortions performed by dilatation and curettage were associated with an estimated fourfold increased risk of developing hemorrhage (OR 4.4, 95% CI 2.2–8.6) and a twofold increased risk of developing fever (OR 2.37, 95% CI 1.17–4.79) compared with the abortions that were performed via vacuum aspiration. The risk of postabortion hemorrhage (OR 1.9, 95% CI 0.8–4.4) or fever (OR 0.9, 95% CI 0.4–2.1) did not significantly differ at gestational age < 10 weeks and ≥10 weeks.ConclusionVacuum aspiration was associated with reduced risks of postabortion hemorrhage and fever compared to dilatation and curettage. Gestational age ≥ 10 weeks was not found to be a predictive factor of immediate postabortion complications: hemorrhage and fever.
Highlights
Every year around 50 million unintended pregnancies worldwide are terminated by induced abortion
Educated women with higher incomes who were from urban areas tended to have abortions at a lower gestation age (
These women were nearly twice as likely to undergo an abortion by Dilatation and curettage (D&C) and at a gestational age ≥ 10 weeks than by vacuum aspiration and at a gestational age of
Summary
Every year around 50 million unintended pregnancies worldwide are terminated by induced abortion. Even in countries, where it is legalized and performed in a safe environment, abortion carries some risk of complications for women. Eighty million women worldwide have an unintended pregnancy annually [1] and around 50 million of them are terminated by induced abortion [2]. High rates (~11 million abortions annually) were documented in the Soviet Union [3]. An abortion complication in countries in which the procedure is legalized is primarily associated with infection, hemorrhage, and uterine injury [7]. The rate of abortion-related morbidity has been reported to be on average 9–10% [8, 9], the range varies markedly across the world from
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