Post-abortion Complications: A Narrative Review for Emergency Clinicians

Author:

Bridwell Rachel1,Long Brit2,Montrief Tim3,Gottlieb Michael4

Affiliation:

1. Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington

2. Brooke Army Medical Center, Department of Emergency Medicine, Fort Sam Houston, Texas

3. Jackson Memorial Health System, Department of Emergency Medicine, Miami, Florida

4. Rush University Medical Center, Department of Emergency Medicine, Chicago, Illinois

Abstract

An abortion is a procedure defined by termination of pregnancy, most commonly performed in the first or second trimester. There are several means of classification, but the most important includes whether the abortion was maternally “safe” (performed in a safe, clean environment with experienced providers and no legal restrictions) or “unsafe” (performed with hazardous materials and techniques, by person without the needed skills, or in an environment where minimal medical standards are not met). Complication rates depend on the procedure type, gestational age, patient comorbidities, clinician experience, and most importantly, whether the abortion is safe or unsafe. Safe abortions have significantly lower complication rates compared to unsafe abortions. Complications include bleeding, retained products of conception, retained cervical dilator, uterine perforation, amniotic fluid embolism, misoprostol toxicity, and endometritis. Mortality rates for safe abortions are less than 0.2%, compared to unsafe abortion rates that range between 4.7-13.2%. History and physical examination are integral components in recognizing complications of safe and unsafe abortions, with management dependent upon the diagnosis. This narrative review provides a focused overview of post-abortion complications for emergency clinicians.

Publisher

Western Journal of Emergency Medicine

Subject

General Medicine,Emergency Medicine

Reference123 articles.

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4. World Population Review. Countries Where Abortion Is Illegal 2022. World Population Review. https://worldpopulationreview.com/country-rankings/countries-where-abortion-is-illegal. Published 2022. Accessed June 27, 2022.

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