Document Detail


Immediate complications after medical compared with surgical termination of pregnancy.
MedLine Citation:
PMID:  19888037     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate the immediate adverse events and safety of medical compared with surgical abortion using high-quality registry data. METHODS: All women in Finland undergoing induced abortion from 2000-2006 with a gestational duration of 63 days or less (n=42,619) were followed up until 42 days postabortion using national health registries. The incidence and risk factors of adverse events after medical (n=22,368) and surgical (n=20,251) abortion were compared. Univariable and multivariable association models were used to analyze the risk of the three main complications (hemorrhage, infection, and incomplete abortion) and surgical (re)evacuation. RESULTS: The overall incidence of adverse events was fourfold higher in the medical compared with surgical abortion cohort (20.0% compared with 5.6%, P<.001). Hemorrhage (15.6% compared with 2.1%, P<.001) and incomplete abortion (6.7% compared with 1.6%, P<.001) were more common after medical abortion. The rate of surgical (re)evacuation was 5.9% after medical abortion and 1.8% after surgical abortion (P<.001). Although rare, injuries requiring operative treatment or operative complications occurred more often with surgical termination of pregnancy (0.6% compared with 0.03%, P<.001). No differences were noted in the incidence of infections (1.7% compared with 1.7%, P=.85), thromboembolic disease, psychiatric morbidity, or death. CONCLUSION: Both methods of abortion are generally safe, but medical termination is associated with a higher incidence of adverse events. These observations are relevant when counseling women seeking early abortion. LEVEL OF EVIDENCE: II.
Authors:
Maarit Niinim?ki; Anneli Pouta; Aini Bloigu; Mika Gissler; Elina Hemminki; Satu Suhonen; Oskari Heikinheimo
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  114     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-11-05     Completed Date:  2009-12-02     Revised Date:  2010-03-04    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  795-804     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents / adverse effects*
Abortion, Induced / adverse effects*
Adult
Cohort Studies
Female
Gestational Age
Humans
Odds Ratio
Pregnancy
Reoperation
Uterine Hemorrhage / etiology*
Vacuum Curettage / adverse effects*
Young Adult
Chemical
Reg. No./Substance:
0/Abortifacient Agents
Comments/Corrections
Comment In:
Obstet Gynecol. 2010 Mar;115(3):660; author reply 660-1   [PMID:  20177301 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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