post abortion complications and incidences.

1. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
ABORTION
COMPLICATIONS

2. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
Complications after surgical abortion
Abortion risks are increased exponentially along with gestational age
Prior history of 2 or more C/S is the strongest predictor of major
complications with D& E
Uterine Perforation
Vacuum aspiration 0.1 – 4/ 1000 procedures
D & E 2 – 3 / 1000 procedures

3. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
Cervical Injuries
Tears 0.1 – 10 / 1000
Retained placental fragments
First Trimester 2 / 100
Second Trimester 3 / 100
Continuing Pregnancy 1 / 1000

4. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
Complications After Medical Abortion
Overall risk 1.6 / 1000
Failed Abortion 5 / 1000
Surgical Intervention 3 – 5 / 1000
Uterine Rupture - occurs in second trimester abortions
& prior c/s delivery
Previous C/S 3 / 1000
Previous NVDs 4 / 10,000

5. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
SUSPECTED DIC - COMMON AFTER MID-TRIMESTER
ABORTIONS 200 / 100,000
Hemorrhage ≤ 13 weeks 0.88 / 1000
≥ 20 weeks 4 / 1000

6. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
Post abortion triad:
Pain, bleeding, and low-grade fevers are the most
common presenting complaints.
Post abortion triad usually is caused by retained
products of conception.
Post Abortion Syndrome – Hematometra
RPOC’s
Uterine Atony

7. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
Bowel injury
Septic abortion - Endometritis.
Patients present with fever, chills, abdominal pain
Failed abortion (continued intrauterine or ectopic pregnancy)
Common with very early abortions (< 6 wk gestational age).

8. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
FAILED ABORTION
&
CONTINUING PREGNANCY

9. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
Risk Of Failure to end pregnancy is less than 1 / 100
5 % cases need further intervention
Risk more after medical terminations ≥ 13 weeks
Risk after suction evacuation
12 weeks & earlier - 2.3 / 1000
Risk greater in multiparous
Abortions at 6 weeks or early
Small sized cannula use
Uterine abnormalities

10. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
Β HCG False positive 66% of times after 2 weeks
20% of times after 4 weeks
Rely First on Persisting Pregnancy symptoms of patient
Followed by Ultrasonography .
Intervention for management
Surgical intervention after failed medical abortion
Re- Evacuation after failed/ incomplete surgical abortion .

11. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011
POST ABORTION INFECTION
SEQUALAE
Genital Tract Infection including PID
Tubal Infertility
Ectopic Pregnancy
Asherman’s Syndrome

12. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011

13. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011

14. Reference: The Care Of Women Requesting Induced Abortion ; Evidence based clinical guideline number 7 RCOG Nov, 2011