The following are some excerpts from the post:
Timing of Complications with Induced Abortion11
- Immediate (within 24 hours): Bleeding, pain
- Uterine perforation
- Cervical lacerations
- Delayed (between 24 hours and 4 weeks): Bleeding or Discharge
- Retained products of conception
- Late complications (> 4 weeks): Amenorrhea
- Immediate (<24 hours) complications of induced abortion include hemorrhage and pain, commonly caused by cervical laceration and uterine perforation.
- Delayed (24 hours – 4 weeks) complications include retained products of conception and infection.
- Key historical features to evaluate induced abortion complication risk are: prior cervical surgery, prior Caesarean section, increased gestational age, and parity.
- Consider early OB-GYN consult in any post-abortion patient
- Risk stratify patients for ectopic pregnancy
- Review pre-procedure imaging for documentation of intrauterine pregnancy
- Ultrasound is a key imaging modality for suspected delayed complications of induced abortion.
- If you suspect septic abortion, cover for normal vaginal flora and sexually transmitted diseases
Resources (These references are all from the above article and the numbering is from the article – Go there to see the complete list.):
- 1. Upadhyay UD, Desai S, Zlidar V, Weitz TA, Grossman D, Anderson P, et al. Incidence of emergency department visits and complications after abortion. Obstetrics and gynecology. 2015;125(1):175-183. [PubMed Abstract]
- 8. Cleland K, Creinin MD, Nucatola D, Nshom M, Trussell J. Significant adverse events and outcomes after medical abortion. Obstetrics and gynecology. 2013;121(1):166-171. [PubMed Abstract] [Full Text HTML] [Full Text PDF]
- 9. Ireland LD, Gatter M, Chen AY. Medical Compared With Surgical Abortion for Effective Pregnancy Termination in the First Trimester. Obstetrics and gynecology. 2015;126(1):22-28. [PubMed Abstract]
- 10. Zane S, Creanga AA, Berg CJ, Pazol K, Suchdev DB, Jamieson DJ, et al. Abortion-Related Mortality in the United States: 1998-2010. Obstetrics and gynecology. 2015;126(2):258-265. [PubMed Abstract] [Full Text HTML] [Full Text PDF]
- 13. Kerns J, Steinauer J. Management of postabortion hemorrhage: release date November 2012 SFP Guideline #20131. Contraception. 2013;87(3):331-342. [PubMed Abstract] [Full Text HTML] [Full Text PDF]
- 14. White K, Carroll E, Grossman D. Complications from first-trimester aspiration abortion: a systematic review of the literature. Contraception. 2015;92(5):422-438. [PubMed Abstract]
- 23. Eschenbach DA. Treating spontaneous and induced septic abortions. Obstetrics and gynecology. 2015;125(5):1042-1048. [PubMed Abstract]