Complication rates and utility of intravenous access for surgical abortion procedures from 12 to 18 weeks of gestation☆
Received 29 November 2009; received in revised form 28 January 2010; accepted 28 January 2010. published online 11 March 2010. Corrected Proof
Abstract
Background
The study was conducted to compare need for intravenous (IV) access and the immediate complication rate in women having an outpatient surgical abortion at 12-1/7 to 15-6/7 weeks gestation (12–15+ weeks) versus 16-0/7 to 18-0/7 weeks of gestation (16–18 weeks).
Study Design
This retrospective cohort study included 1503 women who underwent a surgical abortion (dilation and curettage or dilation and evacuation) in a free-standing outpatient clinic from April 1, 2001, to April 1, 2008. The primary outcome was IV access used for fluids or emergent medications.
Results
Of the procedures, 1216 (81%) were at 12–15+ weeks and 287 (19%) were 16–18 weeks. The incidence of immediate complications that could require IV access was 1.1% and 3.8%, respectively (p=.001). However, most were cervical lacerations that did not require IV fluids or treatments. Major immediate complications (uterine perforation or hospital transfer) occurred in 0.3% and 0.7%, respectively (p=.32). Overall, there were 7 (0.5%, 95% CI 0.1–0.8%) women who required access because of a complication. There were no cases for which IV access was needed emergently and was unable to be obtained.
Conclusions
IV access is rarely medically needed due to an immediate complication from surgical abortion at 12 to 18 weeks gestation. Major complication rates for such procedures are very low. Routine use of IV access at 16–18 weeks solely because of gestational age is not warranted.
aUniversity of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
bMagee-Womens Research Institute, Pittsburgh, PA 15213, USA
cUniversity of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15213, USA
Corresponding author. University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, Pittsburgh, PA 15213-3180, USA. Tel.: +1 412 641 1403; fax: +1 412 641 1133.
☆ This abstract was presented in part as an oral presentation at the Society of Family Planning and Association of Reproductive Health Professionals Annual Meeting, Hollywood, CA, USA, October 1, 2009.
ABSTRACT