Induced abortion by the suction method. An analysis of complication rates

Abstract

3036 induced abortions from the years 1977, 1978, 1979 and 1980 were analysed. They included all abortions performed with the suction method at Akershus Central Hospital, except for those done in combination with a sterilization procedure. The main determinants of complication rates were parity, period of gestation and, for minor complications, whether the patient was treated as an in-patient or an out-patient. Women who had not previously given birth had a higher complication rate than parous women. Complication rates were lowest during weeks 7-10. Out-patients had fewer readmissions, repeat curettages, and infections, than in-patients. There was a tendency to cause a larger dilatation of the cervical canal than was technically necessary.

PIP: Complication rates among all 3036 patients who had pregnancies terminated by suction techniques, under general anesthesia, at Akershus Central Hospital in Norway between 1977-80 were analyzed. Abortions performed in conjuction with sterilizations were not included in the study. Almost all of the abortions were performed during the 1st trimester. A few early 2nd trimester suction abortions were included. Information for the analysis was obtained from medical records. Registered complication variables included prolonged hospital readmissions, perforations, cervical laceratios, blood transfusions, laparotomies, repeat curettages, temperature rises of 38 degrees celsius or more, antibiotic treatments, and infections with or without a palpable pelvic mass. 29.3% of the patients had outpatient sterilizations, and 70.7% had inpatient sterilizations. The only criteria used to select inpatients were age and parity. Outpatient sterilizations were performed by the same medical teams and in the same operating theater as the inpatient sterilizations. Complications were registered for 7.1% of the patients. Complication rates varied by parity, outpatient and inpatient status, and gestational length. The complication rate was 9.2% for nulliparous women, and 5.3% for parous women. The difference was significant (p0.001). Nulliparous women has a higher number of registered temperature rises, antibotic treatments, and infections without palpable pelvic masses than parous women. When only hospitalized nulliparous and parous women were compared the difference in complication rates was smaller, but still significant (p0.03). Hospitalized patients had higher complication rates for minor complications than inpatients, and similar rates for major complications. Only parous patients were compared in regard to inpatient and outpatient differences since there were very few nulliparous outpatients. The complication rate for the 798 parous outpatients was 3.6%, and for the 872 parous inpatients the rate was 6.9%. The difference was significant (p0.001). Even when the length of gestation was controlled, the parous inpatients still had a significantly higher rate of complications than the parous outpatients. Perhaps hospitalized patients were more likely to seek medical attention for minor complaints than outpatients, or perhaps hospitalized patients were more likely to acquire infections than oupatients. In regard to gestation length, the lowest complication rates were observed for abortions performed during the 7th to 10th gestation weeks. After 10 weeks gestation, complication rates tended to increase and the highest rates were observed during the 14 gestation week. Rates at 6 week gestation were also high, especially among nulliparous women. The rate of retained tissue was higher during the 6th week of gestation than during any other week.