Document Detail


Medical versus surgical termination of pregnancy in primigravid women--is the next delivery differently at risk? A population-based register study.
MedLine Citation:
PMID:  23126244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the effect of medical versus surgical termination of pregnancy (TOP), performed in primigravid women, on subsequent delivery.
DESIGN: Population-based register study.
SETTING: Finland 2000-2009.
POPULATION: All primigravid women (n = 8294) who underwent TOP during first trimester of pregnancy by medical (n = 3441) or surgical (n = 4853) method, and whose subsequent pregnancy resulted in singleton delivery.
METHODS: The women were identified in the Finnish Register of Induced Abortions, and the data were linked to the Medical Birth and the Hospital Discharge Registries.
MAIN OUTCOME MEASURES: Risk of preterm birth, low birthweight, small-for-gestational-age (SGA) infant and placental complications (placenta praevia, placental abruption, retained placenta, placenta accreta).
RESULTS: No statistically significant differences in the incidences of preterm birth (4.0% in the medical group versus 4.9% in the surgical group), low birthweight (3.4% versus 4.0%), SGA infants (2.6% versus 2.9%) or placental complications (2.6% versus 2.8%) emerged between the two groups. After adjusting for various background factors, medical TOP was not associated with significantly altered risks of preterm birth (odds ratio [OR] 0.87, 95% confidence interval [95% CI] 0.68-1.13), low birthweight (OR 0.90, 95% CI 0.68-1.19), SGA infant (OR 0.87, 95% CI 0.64-1.20) or placental complications (OR 0.98, 95% CI 0.72-1.34) versus surgical TOP. In a sub-analysis excluding women who underwent surgical evacuation following the index TOP, medical TOP was associated with a reduced risk of preterm birth (P < 0.01), but the difference became insignificant after adjusting for gestational age at the time of TOP, inter-pregnancy interval, maternal age, cohabitation status, socio-economic status, residence and smoking during pregnancy.
CONCLUSIONS: A history of one medical versus surgical TOP, performed in primigravid women, is associated with similar obstetric risks in the subsequent delivery.
Authors:
J Männistö; M Mentula; A Bloigu; E Hemminki; M Gissler; O Heikinheimo; M Niinimäki
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-11-06
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  120     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-15     Completed Date:  2013-03-12     Revised Date:  2013-10-03    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  331-7     Citation Subset:  AIM; IM    
Copyright Information:
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.
Affiliation:
Department of Obstetrics and Gynaecology, University Hospital of Oulu, Oulu, Finland.
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / adverse effects
Abortifacient Agents, Steroidal / adverse effects
Abortion, Induced / adverse effects,  methods*
Adolescent
Adult
Birth Intervals
Dilatation and Curettage / adverse effects
Drug Combinations
Female
Gravidity*
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Small for Gestational Age
Maternal Age
Mifepristone / adverse effects
Misoprostol / adverse effects
Pregnancy
Pregnancy Complications / etiology*
Pregnancy Trimester, First
Registries
Risk Factors
Socioeconomic Factors
Young Adult
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 0/Abortifacient Agents, Steroidal; 0/Drug Combinations; 59122-46-2/Misoprostol; 84371-65-3/Mifepristone
Comments/Corrections
Comment In:
BJOG. 2013 Sep;120(10):1299-300   [PMID:  23941435 ]
BJOG. 2013 Sep;120(10):1300   [PMID:  23941437 ]

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