Cervical ruptures in midtrimester abortions
Rajan, R.; Usha, K.R.
Journal of Obstetrics and Gynaecology of India 29(3): 613-619
1979
ISSN/ISBN: 0971-9202 PMID: 12335921 Document Number: 575218
2 groups of patients are at risk of traumatic complication after midtrimester abortion: older multiparous women (uterine ruptures) and young primigravid women (cervical ruptures). While the occurrence of uterine ruptures in the former class can be reduced by selective use of abortifacient agents, and avoidance of amnioinfusions and intravenous oxytocin, the occurrence of cervical ruptures continues to be high. From May 1974 through May 1978, 780 women underwent midtrimester abortion by various techniques. 12 patients (1.5%) sustained cervical injuries, 11 of whom were nulliparous aged 16 to 25 years. Intra-amniotic and extra-ovular methods alike produced cervical injuries. The combined method of induction increases the likelihood of damaging the cervix. Oxytocic augmentation, however, does not appear to increase its incidence. Nor does a shorter induction-abortion interval, according to the evidence. Since laminaria tents did not prevent cervical injuries, none of the presently available methods offers any protection. Nevertheless, it may be that cervical injuries can be prevented if midtrimester abortions are undertaken between 13 and 15 weeks of pregnancy. Cervical ruptures can also go unnoticed and cause future obstetric problems; the authors therefore emphasize the importance of routine cervical inspection in all patients.