Methods used in first trimester abortion |
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| Affiliation: | 1. Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen, AB9 2ZD, UK;2. Department of Obstetrics and Gynaecology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB9 2ZD, UK;1. Department of Orthopedic Surgery, Loma Linda University, 11406 Loma Linda Drive, Loma Linda, CA, 92354, United States;2. Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, 593 Eddy Street, Providence, RI, 02903, United States;3. Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, 2 Dudley St #200, Providence, RI, 02905, United States;4. Warren Alpert Medical School, Brown University, Providence, RI, 02905, United States;5. Division of Spine Surgery, Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, 593 Eddy Street, Providence, RI, 02903, United States;1. Department of Orthopaedics, University of Utah, Salt Lake City, Utah;2. School of Medicine, University of Utah, Salt Lake City, Utah, U.S.A.;1. Center for Research in Reproductive Health - (CEMICAMP), Campinas, São Paulo, Brazil;2. FIGO Working Group on the Prevention of Unsafe Abortion, Campinas, São Paulo, Brazil;3. Emeritus Professor of State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil;4. State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil |
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| Abstract: | ![]()
In 1990 over 175 000 women underwent legal first trimester abortion in the UK, 98% of which were performed using vacuum aspiration. In developed countries where abortion is legal, this procedure is extremely safe and effective. Maternal mortality occurs in approximately 1 in 100 000 cases. Other serious complications occur in less than 1% of cases and minor complications, including psychological disturbances, in 10% of cases. The procedure has no effect on subsequent fertility or pregnancy outcome, and leads to complete abortion in 95–98% of cases. Cervical priming is consistently associated with decreased morbidity.Medical abortion, using mifepristone in combination with the prostaglandin analogue gemeprost, provides a real alternative which is preferred by at least one-fifth of women. The procedure is as effective as vacuum aspiration and may be more so at very early gestations. There are no major differences in medical, psychological or acceptability outcomes when the procedures are compared. Medical abortion compares favourably with surgical abortion on cost-effectiveness analysis and may be the method of choice at less than 50 days gestation.In the UK other methods of first trimester abortion should be avoided in routine practice. Prompt referral of women with unplanned pregnancies to fertility control services must remain a primary objective in order to minimise adverse maternal health consequences. |
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