ABSTRACT
Hygroscopic dilators (laminaria, synthetic tents) 106 Articial cervical dilator devices 106 Medical dilator 106
Instruments of surgical evacuation 107 Types of surgical instruments used to dilate the cervix 107 Curette 107
Dilation and curettage for evacuation of the uterus 107 Vacuum aspiration (dilation and evacuation) 108 Medical termination of pregnancy 109 Management of missed abortion 111
Follow-up 111 Rh immunization and antibiotic prevention/treatment 111
Complications 112 Cervical laceration 112 False passage 112 Other cervical eects 112 Uterine hemorrhage 112 Perforation 113 Synechiae 113
Prevention of spontaneous abortions 113 Incarceration of the retroexed uterus 114
Procedures for midtrimester-indicated termination 114 Conventional techniques 114
DEFINITION AND CLINICAL PICTURE OF ABORTION Abortion (miscarriage) is the termination of a pregnancy, induced or spontaneous, before the conceptus is suciently developed to survive aer delivery. e precise gestational age at which the infant is able to survive is dicult to dene. Spontaneous abortion is the most common complication of early pregnancy. Most authorities restrict the term “abortion” to the rst 23 weeks of pregnancy; or in retrospect, to the delivery of any infant weighing less than 350 or 500 g. In the following discussion, abortion is dened as expulsion of the products of conception before gestational week 23. Abortions taking place before week 13 are termed early (rst-trimester) abortions; those occurring at weeks 13-23 are called late (second-trimester, midtrimester) abortions. is subdivision into two dierent categories is important because of the dierent etiologies and types of treatment applied.
