[Immediate complications of surgical abortion]. / Complications immédiates de l'IVG chirurgicale.

While medical abortion is now available in non hospital facilities, abortions by vacuum aspiration remain illegal in non hospital settings. It is therefore important to assess through the literature the real risks associated with this method. All the most recent and large-scale studies showed that legal abortion by vacuum aspiration is an extremely safe procedure. It is less risky than other medical or surgical procedures performed outside the hospital. According to the studies, the death rate varies from 0 to 0.7 per 100,000 abortions, and is smaller when the procedure is done under local anesthesia than general anesthesia. The overall early complication rate (hemorrhage, uterine perforation, cervical injury) is between 0.01 and 1.16%. Complications are not more frequent than with medical abortions. In view of these low complication rates, surgical abortion by vacuum aspiration could be performed outside the hospital setting in France, as it is the case in many other countries.

[Pregnancy termination between 12 and 14 weeks gestation: practices and early complications in comparison with termination between 8 and 12 weeks]. / Conditions de réalisation et complications précoces des IVG entre 12 et 14 semaines d'aménorrhée comparées aux IVG entre 8 et 12 semaines d'aménorrhée.

OBJECTIVES: To describe and compare practices and complications of induced abortions (IA) between 12 and 14 gestational weeks (GW) with those performed at lower terms (8-10 and 10-12 GW). PATIENTS AND METHODS: Cohort study enrolled in two IA centers 411 women, 147 of them with 12-14 weeks gestation. Comparisons were made according to pregnancy term (8-10, 10-12 and 12-14 GW). RESULTS: Pregnancy term influenced the technical conditions of IA. Number and diameter of dilators and suction cannula as well as surgery time increase with gestational age--whether priming agents were used or not. Pain felt during surgery and early complications (within 15 days post IA) did not increase with gestational age. CONCLUSION: Results of this study show that IA between 12 and 14 GW are as feasible as with lower terms.

Complications of abortion performed under local anesthesia.

OBJECTIVE: To assess the incidence of complications of abortion performed under local anesthesia. DESIGN: Prospective study. SETTING: A family planning center in the Paris area. POPULATION: Eight hundred and fifty-eight women admitted for abortion under local anesthesia. MAIN OUTCOME MEASURES: Incidence of immediate (the day of vacuum aspiration) and delayed complications (at the follow-up visit 2 weeks after the procedure). RESULTS: Among the 858 women who underwent vacuum aspiration, 683 (80%) attended the follow-up visit 2 weeks after the procedure. Fifty-nine percent of the 858 women had not had a previous abortion, 25% had had one, and 16% had had two or more. The average duration of amenorrhea was 8.6 weeks (19% at 6 or 7 weeks, 67% between 8 and 10 weeks, and 14% after 10 weeks). The overall complication rate was 3.4% (23/683) (95% CI=2.0-4.8%). The incidence of immediate complications was 1.7% (15/858) (0.8-2.6%) and that of delayed complications 1.2% (8/683) (0.4-2.0%). CONCLUSION: This study confirms the safety and efficacy of abortion by vacuum aspiration under local anesthesia.

PIP: A prospective study was conducted in the largest family planning (FP) center in the Paris area, France, to evaluate safety and the incidence of complications in first-trimester abortions (vacuum aspiration technique) performed under local anesthesia. From January 1 to December 31, 1994, 858 women who underwent vacuum aspiration under local anesthesia in the FP center of Colombes Hospital were studied. Of these, 683 attended the follow-up visit 2 weeks after the procedure. The study was not based on sociodemographic characteristics, but rather on the general population requesting abortion under local anesthesia. Results showed that the average duration of amenorrhea was 8.6 weeks. The overall complication rate of abortion using local anesthesia was 3.4%, whereas incidences of immediate complications were 1.7% and 1.2% for delayed complications. The most frequent immediate complication was incomplete abortion. No differences in complication rates were found according to the attending physicians. Neither immediate nor delayed complication rates were associated with the patient's sociodemographic characteristics. Therefore, the results of this study indicate that the risk associated with abortion under local anesthesia was acceptable, and that the incidence of complications was similar to those for other techniques (abortion under general anesthesia and drug-induced abortion). It confirms the efficacy and safety of abortion by vacuum aspiration under local anesthesia.