Results in 1,000 Cases of Therapeutic Abortion Managed by Vacuum Aspiration

Abstract

SummaryA prospective study of 1,000 cases of termination of pregnancy by vacuum aspiration is presented and the safety of the method emphasized. By setting up special clinics and an additional weekly operating session, the maximum delay from a request to appointment is 5 days, and, if operation is advised, from appointment to operation a further 7 days.

Choice of Ecbolic and the Morbidity of Day‐case Terminations of Pregnancy

“…Premedication, given to subjects studied as inpatients, will mask many side effects of drugs. Furthermore, earlier studies of abortion blood losses have used insensitive measurement techniques (Cullen et al, 1970;Loung et al, 1971; Lauerson and Conrad, 1974 Reports have suggested that a myometrial stimulant such as ergometrine will fail to prevent the high blood losses at abortion that may be associated with modifications in anaesthetic methods (Dunn et al, 1973) and the same drug has caused clinical difficulties at operation by inducing bronchospasm (Sellers, 1979) or collapse (Valentine, 1977). Despite this, ergometrinecontaining preparations continue as the most widely used ecbolics during legal termination of pregnancy.…”

Abortion

“…It has been reported as 1 out of 400 procedures by Stone et al [149] and as 6% by Loung et al [150]. This may be due to cervical trauma, uterine perforation, or uterine atony.…”

“…The incidence varies from 0.4% to 2.9% [147][148][149][150] in the first trimester, and may be as much as four times this after 12 weeks gestation [148]. These present as a heavy vaginal blood loss, associated with lower abdominal pain.…”

Implementation of the Abortion Act: Report on a Year's Working of Abortion Clinics and Operating Sessions

“…Where operation is to be carried out by Karman* catheter or where it is to be carried out by Bierer metal suction curette under paracervical block no premedication is given. In the remaining patients, after premedication with Omnopon 10 mg and scopolamine 0-2 mg the patient is given, in the anaesthetic room, intravenous diazepam 10 mg, pentazocine 30 mg, and methohexitone sodium 100 mg together with ergometrine 0 5 mg, a technique described previously (Loung, Buckle, and Anderson, 1971). All arrangements having been made before admission, there is no need for the patient to be seen by a doctor before being taken to the anaesthetic room.…”

“…Vaginal Ternmination.-The technique employed for vaginal termination has been described (Buckle, Anderson, and Loung, 1970;Loung et al, 1971). It has been modified slightly in that we prefer a higher vacuum pressure of 700 mm Hg or more with the Karman suction catheter and we avoid the use of vulsellum forceps by using Allis forceps for grasping the cervix.…”