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  • Title: [A method of vacuum aspiration in early pregnancy in women with a history of severe gynecologic diseases].
    Author: Khoreva LA.
    Journal: Akush Ginekol (Mosk); 1992 Feb; (2):37-9. PubMed ID: 1476226.
    Abstract:
    Early (with the regular menstrual period absent for 6 to 20 days) artificial abortions were carried out in 61 women with a history of uterine myomas, cicatrix on the uterus, and developmental defects of the genitals. Analysis of early complications has shown that their incidence is virtually the same as in healthy women: 3.3%. Vacuum aspiration is an effective and safe method for early artificial abortions. A course of rehabilitation measures in the postoperative period reduces the incidence of early complications and is conducive to timely recovery of the normal cycle. There is a 24% complication rate after first trimester induced abortions using traditional methods. This rate increases significantly in women who have a history of severe gynecological diseases (SGDs), e.g., uterine myoma, scars on the uterus, and developmental defects of the genitals. The goal of this investigation was to shed light on the effectiveness of miniabortion among pregnant women with SGDs. 61 patients aged 21-43 years with SGDs (33 with uterine myomas, 22 with scars, and 6 with uterine developmental defects) who underwent abortion by vacuum aspiration were studied. All women had had 1-3 births and 1-11 abortions. Only one patient with scars required dilatation of the cervix to Hegar 6. 85% of the patients tolerated the operation well, while 15% either had lower abdominal pain or vertigo, which abated soon after the procedure. 3-10 days after the operation slight menstruation reactions developed in 97% women that lasted 1-3 days. In 11% of cases the menstruation reaction was accompanied by pain. In two patients with uterine myoma the bleeding did no stop within 5 days after the abortion. One of these patients had profuse bleeding with clots, and 13 days after abortion she developed postabortal endometritis. One patient with scars became pregnant. The rate of complications amounted to 3.3%. The high risk of postabortal complications owing to the defects of the myometrium necessitated the administration of weak uterine drugs, such as ergotal. Trihopol was also administered for the prevention of inflammation. Starting the fifth day after the beginning of menstruation-like reactions, the patients were started on estrogen-gestagen preparations for contraception for three menstrual cycles. After the end of the menstrual reaction, they were enrolled in rehabilitative physiotherapy: electrophoresis or ultrasound applied to the area of the uterus. Regular menstruation usually resumed 20-30 days after the beginning of the menstrual reaction. The highly effective miniabortion curettage is recommended because of negligible risk of trauma.
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