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Chapter 38 - Termination of Pregnancy

Surgical Methods

from Section 2B - Sexual and Reproductive Healthcare: Termination of Pregnancy

Published online by Cambridge University Press:  16 January 2024

By
Barbara Salje  and
Michelle Cooper
Edited by
Johannes Bitzer  and
Tahir A. Mahmood
Johannes Bitzer
Affiliation:
University Women's Hospital, Basel
Tahir A. Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
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Summary

Surgical termination of pregnancy was the first widespread method of abortion available. However, rates have declined in recent decades across Western Europe due to the increasing popularity of medical methods. In 2018 in England, 29% of abortions were performed surgically and most of these (24%) were by vacuum aspiration (VA)[1]. Vacuum aspiration is the principal technique used for surgical abortion at gestations under 14 weeks. Later surgical abortion is generally achieved by the distinct procedure of dilatation and evacuation (D&E). Sharp curettage in surgical abortion (where the uterine lining is scraped with a metal instrument) is now considered obsolete [2, 3].

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Chapter
Information
Textbook of Contraception, Sexual and Reproductive Health , pp. 233 - 238
Publisher: Cambridge University Press
Print publication year: 2024

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References

Abortion statistics, England and Wales. 2018. http://bit.ly/3DBgIPS.Google Scholar
The care of women requesting induced abortion. 40 B 3270 RCOG Abortion guideline.qxd:3270 RCOG Abortion guideline.qxd 11/11/11.Google Scholar
World Health Organization. Safe abortion: Technical and policy guidance for health systems. 2nd edition. Geneva: World Health Organization, 2011.Google Scholar
Meirik, O, Huong, NT, Piaggio, G et al. Complications of first-trimester abortion by vacuum aspiration after cervical preparation with and without misoprostol: a multicentre randomised trial. Lancet. 2012;379(9828):1817–24.CrossRefGoogle ScholarPubMed
Dean, G, Cardenas, L, Darney, P, Goldberg, A. Acceptability of manual versus electric aspiration for first trimester abortion: A randomized trial. Contraception. 2003;67(3):201–6.CrossRefGoogle ScholarPubMed
Darney, PD, Sweet, RL. Routine intraoperative ultrasonography for second trimester abortion reduces incidence of uterine perforation. Journal of Ultrasound in Medicine. 1989;8(2):71–5.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Abortion care. NICE guideline [NG140]. London: National Institute for Health and Care Excellence, 2019. www.nice.org.uk/guidance/ng140.Google Scholar
Kapp, N, Lohr, PA, Ngo, TD, Hayes, JL. Cervical preparation for first trimester surgical abortion. Cochrane Database Syst Rev. 2010(2): Art. No.: CD007207. https://doi.org/10.1002/14651858.CD007207.pub2.Google Scholar
Low, N, Mueller, M, Van Vliet, HA, Kapp, N. Perioperative antibiotics to prevent infection after first-trimester abortion. Cochrane Database Syst Rev. 2012(3):CD005217. https://doi.org/10.1002/14651858.CD005217.pub2.Google Scholar
Shakir, F, Diab, Y. The perforated uterus. Obstetrician and Gynaecologist. 2013;15:256–61.CrossRefGoogle Scholar
Carlsson, I, Breding, K, Larsson, PG. Complications related to induced abortion: A combined retrospective and longitudinal follow-up study. BMC Womens Health. 2018;18(1):158–64. https://doi.org/10.1186/s12905-018-0645-6.CrossRefGoogle ScholarPubMed
Sawaya, GF, Grady, D, Kerlikowske, K, Grimes, DA. Antibiotics at the time of induced abortion: The case for universal prophylaxis based on a meta-analysis. Obstetrics and Gynecology. 1996;87(5):884–90.Google ScholarPubMed
Hooker, A, Fraenk, D, Brölmann, H, Huirne, J. Prevalence of intrauterine adhesions after termination of pregnancy: A systematic review. European Journal of Contraception & Reproductive Health Care. 2016;21(4):329–35.CrossRefGoogle ScholarPubMed
Mentula, M, Männistö, J, Gissler, M, Heikinheimo, O, Niinimäki, M. Intrauterine adhesions following an induced termination of pregnancy: A nationwide cohort study. BJOG. 2018;125:1424–31.CrossRefGoogle ScholarPubMed
Grimes, DA, Lopez, LM, Schulz, KF, Stanwood, NL. Immediate postabortal insertion of intrauterine devices. Cochrane Database Syst Rev. 2010;(6):CD001777.Google Scholar
National Collaborating Centre for Mental Health. Induced abortion and mental health: A systematic review of the mental health outcomes of induced abortion, including their prevalence and associated factors. London: Academy of Medical Royal Colleges, 2011.Google Scholar
Reeves, MF, Smith, KJ, Creinin, MD. Contraceptive effectiveness of immediate compared with delayed insertion of intrauterine devices after abortion: A decision analysis. Obstet Gynecol. 2007;109:1286–94.CrossRefGoogle ScholarPubMed

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