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  • Title: The effect of termination of pregnancy on maturity of subsequent pregnancy.
    Author: Ratten GJ, Beischer NA.
    Journal: Med J Aust; 1979 Jun 02; 1(11):479-80. PubMed ID: 470694.
    Abstract:
    Therapeutic termination of pregnancy performed during the first trimester was associated with a statistically significant increase in the incidence of second trimester abortion and of premature labour in the next pregnancy. In a series of 520 patients who had previously been aborted 8.1% suffered a mid-trimester abortion in their next pregnancy and 8.6% had premature onset of labour (compared to 2.4% (P less than 0.001) and 4.4% (P less than 0.01) respectively in a control series). The incidence of incompetence of the cervix after termination of pregnancy was 4.4%. Studies have shown conflicting results regarding the increase in the incidence of second trimester abortion in subsequent pregnancies following termination of pregnancy during 1st trimester. This prospective study attempts to evaluate the effect of abortion on subsequent reproductive performance. 520 consecutive patients from the Mercy Maternity Hospital and Royal Women's Hospital in Melbourne who had had vaginal termination of a first trimester pregnancy comprised the study group. 500 consecutive patients who had had spontaneous abortion (1st trimester) treated by curettage comprised the control group. The results showed that the incidence of 1st trimester abortion was the same in both control and study groups. The incidence of spontaneous 2nd trimester abortion was 8.1% in the study group, compared with 2.4% in the control group (P 0.001). The study group also had a significantly higher incidence of premature delivery (8.6%) compared to the controls (4.4%; P 0.01). An unexpected result was that a previous mature pregnancy did not protect against complications after pregnancy termination. It appears that dilatation of the cervix physiologically during normal labor and delivery to a diameter of 10 cm. is more beneficial to cervical function in a subsequent pregnancy than dilatation to 10 mm. before therapeutic abortion of a 1st trimester pregnancy. The finding suggests that patients contemplating pregnancy terminations must be told of risk of cervical incompetence; their future obstetricians must also be informed of any abortion performed. In future pregnancies, patients with a history of abortion should be evaluated for evidence of incompetence for proper medical management.
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