Complications of first-trimester abortion by vacuum aspiration after cervical preparation with and without misoprostol: a multicentre randomised trial

Meirik, Olav; Huong, Nguyen Thi My; Piaggio, Gilda; Bergel, Eduardo; Hertzen, Helena von

doi:10.1016/s0140-6736(11)61937-5

Cited by 54 publications

(35 citation statements)

References 18 publications

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“…In other studies, follow-up periods ranged from 2 to 4 weeks with most considering follow-up a return visit to the original abortion facility. When reported, loss to followup varies widely: 9% at 1 week, 7 2-34% at 2 weeks, 5,8,9 and between 8 and 65% in studies where duration is not specified. 22,23 Additionally, this study has the sample size necessary to robustly estimate rare events.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, complication rates are underestimated by low followup rates. 5,[7][8][9] Published complication rates are considered incomplete because they usually do not include those diagnosed at sites other than the original source of care. 10 Limited research focuses on emergency department (ED) use when examining postabortion care.…”

Section: Million Induced Abortions In the Unitedmentioning

confidence: 99%

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Incidence of Emergency Department Visits and Complications After Abortion

Upadhyay

Desai

Zlidar

et al. 2015

Obstetrics &Amp; Gynecology

201

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OBJECTIVE: To conduct a retrospective observational cohort study to estimate the abortion complication rate, including those diagnosed or treated at emergency departments (EDs). METHODS:Using 2009-2010 abortion data among women covered by the fee-for-service California Medicaid program and all subsequent health care for 6 weeks after having an abortion, we analyzed reasons for ED visits and estimated the abortion-related complication rate and the adjusted relative risk. Complications were defined as receiving an abortion-related diagnosis or treatment at any source of care within 6 weeks after an abortion. Major complications were defined as requiring hospital admission, surgery, or blood transfusion. RESULTS:A total of 54,911 abortions among 50,273 feefor-service Medi-Cal beneficiaries were identified. Among all abortions, 1 of 16 (6.4%, n53,531) was followed by an ED visit within 6 weeks but only 1 of 115 (0.87%, n5478) resulted in an ED visit for an abortionrelated complication. Approximately 1 of 5,491 (0.03%, n515) involved ambulance transfers to EDs on the day of the abortion. The major complication rate was 0.23% (n5126, 1/436): 0.31% (n535) for medication abortion, 0.16% (n557) for first-trimester aspiration abortion, and 0.41% (n534) for second-trimester or later procedures. The total abortion-related complication rate including all sources of care including EDs and the original abortion facility was 2.1% (n51,156): 5.2% (n5588) for medication abortion, 1.3% (n5438) for first-trimester aspiration abortion, and 1.5% (n5130) for second-trimester or later procedures.CONCLUSION: Abortion complication rates are comparable to previously published rates even when ED visits are included and there is no loss to follow-up. 1 accurate estimates of abortion complications are paramount to assess and improve quality of care and determine how public policies can most effectively safeguard women's health. Although national abortion-related mortality data exist for the United States, 2 no surveillance system captures abortion-related morbidity. Studies find varying complication rates 3-7 depending on the procedure, weeks of gestation, length of follow-up, and protocols used to detect complications. Furthermore, complication rates are underestimated by low followup rates. 5,[7][8][9] Published complication rates are considered incomplete because they usually do not include those diagnosed at sites other than the original source of care. 10From the Advancing New Standards in Reproductive Health

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Section: Discussionmentioning

confidence: 99%

Section: Million Induced Abortions In the Unitedmentioning

confidence: 99%

Incidence of Emergency Department Visits and Complications After Abortion

Upadhyay

Desai

Zlidar

et al. 2015

Obstetrics &Amp; Gynecology

201

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“…El porcentaje de perforación uterina fue menor al 1%, siendo similar a lo publicado en la literatura (21).…”

Section: Discussionunclassified

Efectividad del tratamiento médico con misoprostol según dosis administrada en aborto retenido menor de 12 semanas

Errázuriz

et al. 2014

Rev. chil. obstet. ginecol.

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“…Un essai randomisé multicentrique suisse récent a comparé en double aveugle les risques de complications survenant dans les deux semaines après une aspiration chirurgicale au cours d'une interruption jusqu'à 12 semaines d'aménorrhée (SA) en fonction de la réalisation d'une pré-paration cervicale trois heures avant le geste par une dose vaginale de 400 g de misoprostol (n = 2485) ou de l'administration d'un placebo (n = 2487) [2]. La dilatation cervicale moyenne et la durée moyenne de la procédure chirurgicale étaient respectivement et significativement plus importante (p < 0,0001) et plus courte (p < 0,0001) dans le groupe misoprostol.…”

Section: Résultats Préparation Cervicale Sur Utérus Gravide Avant Traunclassified

“…La dilatation cervicale moyenne et la durée moyenne de la procédure chirurgicale étaient respectivement et significativement plus importante (p < 0,0001) et plus courte (p < 0,0001) dans le groupe misoprostol. La survenue d'au moins une complication (déchirure cervicale, perforation utérine, aspiration incomplète, infection utérine) était significativement moins fréquente dans le groupe misoprostol que dans le groupe placebo, respectivement 2 et 3 % ( [2]. Enfin, une étude randomisée américaine (125 femmes) a comparé une dose de 400 g de misoprostol administrée par voie buccale (préjugale) à la pose de dilatateurs osmotiques trois à quatre heures avant une interruption chirurgicale de grossesse entre 12 et 15 SA [3].…”

Section: Résultats Préparation Cervicale Sur Utérus Gravide Avant Traunclassified

Misoprostol : utilisation hors AMM au premier trimestre de la grossesse (fausses couches spontanées, interruptions médicales et volontaires de grossesse)

Beucher¹,

Dolley

Carles³

et al. 2014

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Complications of first-trimester abortion by vacuum aspiration after cervical preparation with and without misoprostol: a multicentre randomised trial

Cited by 54 publications

References 18 publications

Incidence of Emergency Department Visits and Complications After Abortion

Incidence of Emergency Department Visits and Complications After Abortion

Efectividad del tratamiento médico con misoprostol según dosis administrada en aborto retenido menor de 12 semanas

Misoprostol : utilisation hors AMM au premier trimestre de la grossesse (fausses couches spontanées, interruptions médicales et volontaires de grossesse)

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