Uterine Perforation in Connection with Vacuum Aspiration for Legal Abortion

Abstract

ABSTRACT The incidence of uterine perforation complicating vacuum aspiration for legal termination of first trimester pregnancy varies widely. Nineteen cases of perforation (0.64%) occurred 1967–1974 at the Department of Obstetrics and Gynecology, Karolinska Sjukhuset, Sweden. These cases were analysed and compared with 71 other reported uterine perforations. The dilator, suction curette and uterine sound were about equally the instrument responsible for perforation. The dilatation of the cervix is a critical point of the operation. In 22% the lesion was observed in the cervix‐isthmus. If this procedure could be replaced by administration of prostaglandins the number of perforations might be reduced. Correct judgement of uterine position and size immediately prior to operation appears to be of utmost importance.