Obsterics
Early surgical abortion: Efficacy and safety,☆☆

https://doi.org/10.1067/mob.2002.123898Get rights and content

Abstract

Objective: Because of concern over the higher rates of failed abortion, many clinicians defer surgical abortion until 7 menstrual weeks or later. We conducted this study to evaluate the efficacy and safety of early surgical abortions that are performed by numerous physicians in a community-based setting. Study Design: We prospectively gathered data on all eligible patients who had surgical abortions at <6 weeks of gestation at 3 Planned Parenthood clinics from January 1, 1998, to August 31, 2000. Outcomes were evaluated with the use of proportions with 95% CI and χ2 analysis. Results: A total of 1132 women had early surgical abortions during the study interval, and follow-up was available for 750 of those women (66%). Seventeen women (2.3%; 95% CI, 1.4%, 3.7%) had failed attempted abortions. Other complications occurred in 13 women. Conclusion: Early surgical abortion is safe and effective. In this series, the frequency of complications that required curettage was similar to that reported with mifepristone and vaginal misoprostol. (Am J Obstet Gynecol 2002;187:407-11.)

Section snippets

Material and methods

The Planned Parenthood League of Massachusetts initiated early surgical abortion services in January 1998. All physicians who performed the procedures had extensive experience in surgical abortion provision, and they were specifically trained and approved to perform early surgical abortions by the first author. The physicians followed the early surgical abortion protocol that had been established by the Massachusetts affiliate in accordance with medical standards and guidelines of the Planned

Results

A total of 1132 eligible women had an early surgical abortion at Planned Parenthood between January 1, 1998, and August 31, 2000. Characteristics of the study population are presented in Table I.

. Patient (n = 1132) characteristics

CharacteristicEmpty Cell
Age (y)27 ± 7*
Gravidity (No.)3 (1-13)†
1329 (29%)
2220 (19%)
3185 (16%)
4157 (14%)
≥5241 (21%)
Parity (No.)1 (0-7)†
0503 (44%)
1285 (25%)
2223 (20%)
≥3121 (11%)
Previous induced abortion (No.)554 (49%)
Body mass index (kg/m2)24 ± 6 *
Gestational age (d)‡35 ± 4*
21-277

Comment

In this large prospective case series, early surgical abortion proved to be safe and effective. The overall complication rate among women with follow-up was 4%, and only 2% of women had failed attempted abortions. The study did not identify any specific risk factors for failed abortion, but its power was limited by the small number of complications. The higher failure rate in women who required both manual and electric vacuum aspiration probably reflects technically challenging cases (ie, the

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The opinions expressed in this article do not necessarily reflect those of Planned Parenthood Federation of America, Inc.

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