Abstract

PIP: 1668 abortions were performed by a New York physician using suction curettage with the Karman cannula (1379 cases) or the Sorenson cannula (289 cases) which resulted in 6 uterine perforations. Of these, 3 resulted in subsequent hysterectomies with 1 death. Perforation rates were 2.9 for the Karman cannula and 6.9 for the Sorenson cannula. All 6 patients were under 30 years of age and had fewer than 3 prior live births. The total perforation rate of 3.6 per 1000 abortions for this physician was similar to rates reported in the Joint Program for the Study of Abortions. The risk of perforation increased sharply with length of gestation, ranging from 0 at 10 weeks or less to 96.8 per 1000 at 15 weeks or more. Results indicate that miscalculation of the patients' gestation was the major cause of complications rather than inexperience or poor techniques and emphasize the need to properly diagnose the length of gestation between 10-16 weeks. It is suggested that the risk of perforation can be greatly reduced by the use of suction curettage in women less than 12 weeks from last menstruation. The fact that these cases were found in 5 different hospitals demonstrated the importance of establishing a national abortion surveillance system.