{
    "abstract": "The incidence of uterine perforation while performing legal abortions was evaluated in the Stockholm area. Among 84,850 legal abortions performed during 1982-1992 there were 145 cases of uterine perforation, 0.17%. In about half of these cases an immediate exploration of the abdomen was decided upon and in 18 patients there were significant bleeding and/or lacerations to organs situated in the pelvis. No case of intestinal perforation was encountered. It is likely that many of these injuries would have healed just as well unattended. Based on this study, the authors advocate a conservative approach in dealing with uterine perforation in connection with vacuum aspiration for legal abortion.\nIn Sweden, where abortion is legal during the first 18 weeks of pregnancy, uterine perforation is the most serious potential complication. An analysis of the 84,850 legal induced abortions performed at the six public hospitals in Stockholm, Sweden, in 1982-92 revealed 145 cases (0.17%) of uterine perforation. 49 (33.8%) of these women had experienced at least one prior induced abortion. In women where uterine size exceeded 12 weeks of pregnancy, there were only four instances (2.8%) of uterine perforation. The perforation was caused by the suction cannula in 69 women (47.0%) and by the Hegar dilator in 30 women (20.6%). Immediate exploration of the abdomen (primarily laparotomy) was performed in 69 (47.6%) of these cases; significant bleeding and/or lacerations to organs situated in the pelvis were identified in 18 (26.1%) of these women. There were no cases of intestinal perforation. The majority of injuries would have healed without laparotomy. Unless peritoneal irritation, increasing pain, and signs of blood loss are present, a conservative approach to uterine perforation is recommended.",
    "authors": [
        {
            "affiliation": "Department of Woman and Child Health, Karolinska Hospital, Stockholm, Sweden.",
            "firstname": "G",
            "initials": "G",
            "lastname": "Lindell"
        },
        {
            "affiliation": null,
            "firstname": "F",
            "initials": "F",
            "lastname": "Flam"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.3109/00016349509024431",
    "journal": "Acta obstetricia et gynecologica Scandinavica",
    "keywords": [
        "Abortion, Induced--complications",
        "Biology",
        "Developed Countries",
        "Diseases",
        "Europe",
        "Family Planning",
        "Fertility Control, Postconception",
        "Genitalia",
        "Genitalia, Female",
        "Incidence",
        "Laparotomy--indications",
        "Measurement",
        "Northern Europe",
        "Perforations",
        "Physiology",
        "Research Methodology",
        "Research Report",
        "Sampling Studies",
        "Scandinavia",
        "Studies",
        "Surgery",
        "Surveys",
        "Sweden",
        "Treatment",
        "Urogenital System",
        "Uterine Effects",
        "Uterine Perforation",
        "Uterus"
    ],
    "methods": null,
    "publication_date": "1995-05-01",
    "pubmed_id": "7778431",
    "results": null,
    "title": "Management of uterine perforations in connection with legal abortions.",
    "xml": "<Element 'PubmedArticle' at 0x7885030feac0>"
}