Medical and Surgical Methods of Early Termination of Pregnancy

• Published in: Proceedings of the Royal Society of London. Series B, Biological sciences Biological sciences, 1976-12, Vol.195 (1118), p.115-127
• Main Author: Filshie, G. M.
• Format: Article
• Language: English
• Subjects: Abortifacient Agents - administration & dosage; Abortion; Abortion, Induced - methods; Contraception; Contraceptives, Postcoital, Hormonal; Corpus Luteum - drug effects; Curettes; Estrogens; Evaluation of Existing Techniques; Female; Humans; Medical syringes; Menstruation; Menstruation - drug effects; Pregnancy; Pregnancy Trimester, First; Prostaglandins; Prostaglandins - pharmacology; Regional Blood Flow - drug effects; Side effects; Uterus; Uterus - blood supply; Uterus - drug effects
• ISSN: 0962-8452; 0080-4649; 0950-1193; 1471-2954; 2053-9193
• DOI: 10.1098/rspb.1976.0102

The demand for effective 'hindsight' or post-conceptual methods of family planning appears to be increasing throughout the world. Medical methods are appealing, because potentially they may be self-administered. At present, prostaglandins or their 15-methyl analogues are being studied on patients who are up to one month late with their menses. Of all the routes used the vaginal route appears the best. Side effects include nausea, vomiting, diarrhoea and abdominal cramps and these often need medication to counteract them. The methods are well short of 100% efficiency. Accurate diagnosis of pregnancy and gestation is often a problem and this renders the method unsuitable for an 'over the counter' self-administration pill. Since the introduction of the 'menstrual extraction' syringe and the Karman curette, termination of pregnancy at up to 8 weeks of amenorrhoea has become substantially easier and safer, especially when combined with local anaesthetics. Dilation is rarely required and the whole procedure rarely takes more than 5-10 min. Post-operative complications appear few and acceptable.