Complication rates and utility of intravenous access for surgical abortion procedures from 12 to 18 weeks of gestation☆

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.

Keywords: Abortion, Intravenous access, Dilation and curettage, Dilation and evacuation, Complications