OBJECTIVES: To determine the incidence of hysterotomy in second trimester termination
of pregnancy, including differences in women that abort following medical induction and
those that fail to abort requiring surgical abortion, and the factors that influence choice of
surgical operation.
METHOD: Records of all women (n=1080) who presented for elective second termination
of pregnancy (14-20weeks) in the years 2008 until 2010 were reviewed retrospectively.
Theatre records were also used to verify the operation. The women were divided into two
groups according to the method of abortion they finally responded to: a medical group that
aborted following medical induction (n=1715), and a surgical group that failed to abort
following medical induction (n=88). Apart from demographics, the surgical group was
studied further in detail of previous uterine operation, surgical operation done for current
abortion, complication profile and seniority of operating surgeon. RESULTS: Failed medical induction accounted for 5% of all second trimester abortions. The
incidence of hysterotomy was 52% in the surgical group and 2.5% of all the second trimester
abortions. Hysterotomy was more common in higher gestations (p=0.005). Suction curettage
was frequent as a surgical abortion method in gestations below 16 weeks. Nulliparous women
were more likely to fail to abort than multiparous women (p=0.002) and those with twin
pregnancy more likely to abort on medical induction (p<0.001). Surgical evacuation was
done mostly by registrars and consultants (senior members of staff). The two common
complication profiles were haemorrhage and incomplete evacuation of the uterus. No cases of
uterine perforation were identified, and there were no intensive care unit admissions and no
deaths.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/14595 |
| Date | 25 April 2014 |
| Creators | Gamedze, Audrey Gugu |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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