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Complications

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • 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:

  1. Lohr PA et al. Abortion.  BMJ 2014;348:f7553

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