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  • Title: [Recommendations for abortion technics].
    Author: Ehrig E, Schott G.
    Journal: Z Arztl Fortbild (Jena); 1981 Apr 01; 75(7):305-8. PubMed ID: 7281770.
    Abstract:
    From a retrospective study on induced abortions carried out in East Germany the effects of abortion on subsequent fertility are summarized as follows: 1) the 1st pregnancy following abortion often ends in miscarriage or premature birth; 2) the technic of abortion determines the outcome of subsequent pregnancy; careful dilatation and the most physiologic method are recommended to prevent miscarriage and/or cervix insufficiency; 3) there is a 10.17% risk of prematurity following abortion as against a 5.49% overall risk; and 4) about 70% of pregnancies following abortion result in labor starting in 37th-39th week. Most abortion complications occur in the initial 3 days. Especially hazardous are forced dilatation of the cervix and wide dilatation of the cervix in primigravidas and multigravidas with scar tissue formation. Curettage with the abortion forceps is more hazardous than suction curettage, 50% less risk in the latter method. A 2nd abortion with long induction time and high microbial ascending contamination has a 11.4% complication rate. Hysterotomy in advanced pregnancy has more complications. Recommendations for risk reduction are: 1) use of a flexible or rigid suction catheter (Karman size 8) up to the 8th week of pregnancy; follow-up with curettage for placenta residuals; 2) with normal dilatation risk use Hegar dilatation with vacuum extraction and control curettage; lumen width to be determined by pregnancy week and not to exceed Hegar 12 (12 mm); 3) with increased dilatation risk in the 1st trimester priming with prostaglandin; laminaria are also useful; and 4) with a 2nd pregnancy reserved for 2nd trimester; induction with prostaglandins. Broad-spectrum antibiotics should be used to minimize risk of infection. The author has constructed a model in the form of a disk useful in assessing abortion risks. It is based on extensive statistics and gives particulars about use of abortion results, diagnosis and indications for methods to be used.
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