The value of peroperative ultrasound examination in first trimester legally induced abortion
Mikkelsen, A.L.; Felding, C.
Clinical and Experimental Obstetrics and Gynecology 21(3): 150-152
1994
ISSN/ISBN: 0390-6663 PMID: 7923793 Document Number: 435871
Despite curettage after vacuum aspiration of induced first trimester abortions, some patients experience signs and symptoms of retained placental tissue. A prospective study was conducted to evaluate the use of postoperative ultrasound examination in the prediction of an empty uterus in induced abortion and to study the effect of preoperative ultrasound on the rate of complications after legal termination in the first trimester. The study was conducted among 117 women, 18-48 years old, who were referred for legally induced first trimester abortion with their consent. The abortions were performed under general anaesthesia by vacuum aspiration followed by blunt curettage of the cavity, by surgeons with varying experience. 10 iu of oxytocin were given intravenously to each women at the end of the operation. Abdominal ultrasound examination was performed after the completion of the procedure. The uterus was examined longitudinally and transversely using an Ultrasound Scanner type 1846 equipped with a 3 mhz abdominal transducer. Dense echoes in the uterus cavity indicated retained tissue and the procedure with aspiration and/or curettage was performed repeatedly until a clearly defined echo cavity was found. The women were discharged the same day. Complications requiring readmission within the first month were registered. No preoperative complications were registered. 6 women were readmitted within one month after abortion because of bleeding and pain, and recurettage was performed in 5 women because of clinical signs of retained tissue. Retained pregnancy products were demonstrated histopathologically only in 3 patients, while another 2 patients were treated with antibiotics because of asymptomatic positive chlamydia culture. The study demonstrated a predictive value of an empty uterus of 97.3% at ultrasound examination. The rate of retained tissue was not reduced compared to other studies that did not use ultrasound examination. The findings of the study therefore suggest that ultrasound examination is valuable when retention of products is suspected, but it cannot be recommended as routine for all patients.