Transvaginal ultrasound after first‐trimester uterine evacuation reduces the incidence of retained products of conception

Debby, A.; Malinger, G.; Harow, Ethan; Golan, Abraham; Glezerman, Marek

doi:10.1002/uog.2654

Cited by 37 publications

(31 citation statements)

References 16 publications

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“…Specifically, training may need to focus on examination of the products of conception immediately after the procedure to determine whether all products have been removed. Other options include use of transvaginal ultrasound after the CAC procedure would also aid in determining whether products of conception remain [13]; however investment in this technology would be most cost-effective in facilities with a high caseload and is not generally feasible in a low resource setting, such as Nepal. In addition, facilities may reduce their cases of RPOC through administration of oxytocics such as methargin after the CAC procedure to aid in the expulsion of small fragments of products of conception not removed during the procedure [12].…”

Section: Discussionmentioning

confidence: 99%

A prospective study of complications from comprehensive abortion care services in Nepal

Andersen¹,

Ganatra²,

Stucke

et al. 2012

BMC Public Health

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BackgroundIn March 2002, Nepal's Parliament approved legislation to permit abortion on request up to 12 weeks of pregnancy. Between 2004 and 2007, 176 comprehensive abortion care (CAC) service sites were established in Nepal, leading to a rise in safe, legal abortions. Though monitoring systems have been developed, reporting of complications has not always been complete or accurate. The purpose of this study was to report the frequency and type of abortion complications arising from CAC procedures in different types of facilities in Nepal.MethodsA total of 7,386 CAC clients from a sample of facilities across Nepal were enrolled over a three-month period in 2008. Data collection included an initial health questionnaire at the time of abortion care and a follow-up questionnaire assessing complications, administered two weeks after the abortion procedure. A total of 7,007 women (95%) were successfully followed up. Complication rates were assessed overall and by facility type. Multivariable logistic regression was used to assess the association between experiencing a complication and client demographic and facility characteristics.ResultsAmong the 7,007 clients who were successfully followed, only 1.87% (n = 131) experienced signs and symptoms of complications at the two-week follow up, the most common being retained products of conception (1.37%), suspected sepsis (0.39%), offensive discharge (0.51%) and moderate bleeding (0.26%). Women receiving care at non-governmental organization (NGO) facilities were less likely to experience complications than women at government facilities, adjusting for individual and facility characteristics (AOR = 0.18; 95% CI: 0.08-0.40). Compared to women receiving CAC at 4-5 weeks gestation, women at 10-12 weeks gestation were more likely to experience complications, adjusting for individual and facility characteristics (AOR = 4.21; 95% CI: 1.38-12.82).ConclusionsThe abortion complication rate in Nepali CAC facilities is low and similar to other settings; however, significant differences in complication rates were observed by facility type and gestational age. Interventions such as supportive supervision to improve providers' uterine evacuation skills and investment in equipment for infection control may lower complication rates in government facilities. In addition, there should be increased focus on early pregnancy detection and access to CAC services early in pregnancy in order to prevent complications.

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Section: Discussionmentioning

confidence: 99%

A prospective study of complications from comprehensive abortion care services in Nepal

Andersen¹,

Ganatra²,

Stucke

et al. 2012

BMC Public Health

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show abstract

“…Transvaginal ultrasound reportedly has been used just after first trimester uterine evacuation to reduce the incidence of RPOC; for this reason, different endometrial thickness cutoff values such as 8 mm and 13 mm have been determined in different studies (13,14). In our study, despite the fact that a statistically significant difference was not found between the groups regarding RPOC, patients in the study group had no RPOC.…”

Section: Discussionmentioning

confidence: 69%

Sublingual misoprostol after surgical management of early termination of pregnancy

Mulayim

Çelik

Önalan

et al. 2009

Fertility and Sterility

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“…Blood loss more than 100 mL was also found in a small portion of patients 19 . However, heavy bleeding for which patients need to be admitted to hospital was uncommon 20 . The amount of blood loss during the treatment of incomplete abortion should not be more than that of termination of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Comparison of efficacy of modified electric vacuum aspiration with sharp curettage for the treatment of incomplete abortion: Randomized controlled trial

Kittiwatanakul

Weerakiet

2012

J of Obstet and Gynaecol

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Transvaginal ultrasound after first‐trimester uterine evacuation reduces the incidence of retained products of conception

Abstract: Objective To assess the incidence of retained products of conception (RPOC)

Cited by 37 publications

References 16 publications

A prospective study of complications from comprehensive abortion care services in Nepal

A prospective study of complications from comprehensive abortion care services in Nepal

Sublingual misoprostol after surgical management of early termination of pregnancy

Comparison of efficacy of modified electric vacuum aspiration with sharp curettage for the treatment of incomplete abortion: Randomized controlled trial

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