A fall in cervical resistance to dilatation for first-trimester-induced abortions has been observed in previous studies and considered a sign of tearing of the cervical tissue. In a study of 104 patients undergoing first-trimester abortion a fall in resistance was found in 12.5 % of women in whom the cervix was dilated to 9 mm, and in 66.7% when dilatation reached 11 mm. No difference between parous and nulliparous women was found.

Experience of 32 cases of symphysiotomy carried out in Mozambique and in Botswana is reviewed. Of all cases only 1 was lost to follow-up. The observation period varied from 7 days to 6 months. Among 31 cases examined at discharge or on return for check-up few complications occurred. Vaginal laceration occurred in 3 cases, haematuria in 1 case and wound infection in 1 case. In 2 cases there was significant postoperative pain causing gait problems, but in no case were there significant problems with pain at discharge or at follow-up. It is concluded that the intervention is seldom complicated by severe sequelae, provided strict adherence to given indications is respected. In rural areas in the third world symphysiotomy is a life-saving and simple surgical intervention, which should be regarded as an adjunct measure in some cases with a moderately contracted pelvic outlet incompatible with normal vaginal delivery.

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