complications
Last edited 02/2022
- Continuing pregnancy:
- seen in 0.2% performed at a gestation of 12 weeks or less
- high risk of failure after a procedure observed in
- multiparous women
- six weeks’ gestation or less
- inexperienced surgeons performing abortions
- women with uterine abnormalities
- in early medical abortion with mifepristone-misoprostol regimens, a continuing pregnancy rate of 0.5%-0.7% has been reported
- more common with the use of oral or lower doses of misoprostol
- repeated dose of misoprostol is effective in less than 40% of cases, hence vacuum aspiration is recommended
- Incomplete abortion:
- results in prolonged bleeding and uterine cramping
- vacuum aspiration or misoprostol can be used
- frequency of reaspiration after first trimester surgical abortion is 0.3-2% while in second trimester it is 0.4–3%
- Haemorrhage that often requires transfusion:
- after early medical abortion blood transfusion is necessary in 0.1% while in later medical abortions the figure slightly rises to 0.7%
- Cervical damage:
- cervical incompetence and subsequent middle trimester abortion
- Uterine trauma, which occurs in 0.1–0.4% of surgical abortions.
- Failed operation.
- Sepsis:
- antibiotic prophylaxis is beneficial in surgical abortion but its use in medical abortion is less clear (1)
- Sensitization of a Rh-negative woman.
- Acute renal failure, possibly secondary to septic shock and hypovolaemia.
Reference: