The hazards of vacuum aspiration in late first trimester abortions

The incidence of somatic complications in connection with legal termination of pregnancy by vacuum aspiration was analysed in 1,123 hospital patients. Special attention was paid to complication rates in relation to gestational age. It was found that the incidence of major uterine haemorrhage increased with gestational period, being unexpectedly high in the 12th week. When anaesthesia was supplemented with halothane there was a significantly higher incidence of uterine haemorrhage that when this anaesthetic was avoided. The results indicate that strict principles for the operation procedure are mandatory to reduce blood loss and other complications. It is suggested that the end of the 12th week should not be considered as a "magic" time limit for vaccum aspiration but that the policy should aim at early intervention, preferably before the end of the 10th week. In the event of late first trimester abortions or "border line" cases it is of advantage to administer prostaglandin extra-amniotically for pre-operative dilatation of the cervix.