Complications of first-trimester abortion: a report of 170,000 cases

One hundred seventy thousand first-trimester abortions were performed in three free-standing clinics of Planned Parenthood of New York City from 1971-1987. Seventy percent of the procedures were done under local anesthesia; the remainder under intravenous methohexital. No preoperative medications or routine postoperative antibiotics were given. High-risk patients were referred to a hospital. The clinics operated under uniform written guidelines. Experienced physicians performed the procedures. There were no deaths in this series of patients. One hundred twenty-one patients were hospitalized (0.71 per 1000) for suspected perforation, ectopic pregnancy, hemorrhage, sepsis, or recognized incomplete abortion. There was no major extirpative surgery performed. There were an additional 1438 minor complications (8.46 per 1000). Overall, there were 9.05 complications per 1000 abortions. The complication rates for procedures done under general anesthesia and local anesthesia were similar. We conclude that outpatient abortion on selected patients to the 14th week from the last menstrual period is a safe procedure.