The incidence and character of the bacteremia associated with elective suction abortion was investigated in volunteer subjects aged 19 to 35 years who were to undergo first trimester abortion by suction curettage. One hundred and forty-four blood cultures were obtained from thirteen pregnant and four non-pregnant (control) subjects matched for age. Transient bacteremia occurred during or soon after suction abortion in 11 of 13 (84.7%) study subjects. Four of these patients were bacteremic after bimanual pelvic examination, just prior to initiation of the abortion procedure. Seven others developed bacteremia temporally related to cervical dilatation and suction abortion. The bacteremia was intermittent in some, persistent in others, existed as long as one hour after the procedure, and was transient in all patients. Microorganisms isolated from the blood were all normal genital tract flora and were predominantly anaerobes, although alpha hemolytic streptococci were also recovered. Mixed bacteremia occurred in six patients. In contrast, blood cultures from four non-pregnant women were sterile. This study indicates that the systemic circulation-uterine cavity barrier is significantly disrupted during abortion by suction curettage permitting endogenous genital tract microorganisms to gain access into the bloodstream. These observations also suggest that there may be some risk of developing endocarditis during suction abortion in patients with cardiac deformities, and lend some support to the current practice of giving antibiotic prophylaxis to abortion patients with cardiac lesions which predispose them to endocarditis.

Transient bacteremia due to suction abortion: implications for sbe antibiotic prophylaxis

This article traces the establishment of abortion clinics following Roe v Wade. Abortion clinics followed one of two models: (1) a medical model in which physicians emphasized the delivery of high quality medical services, contrasting their clinics with the back-alley abortion services that had sent many women to hospital emergency rooms prior to legalization, or (2) a feminist model in which clinics emphasized education and the dissemination of information to empower women patients and change the structure of women's health care. Male physicians and feminists came together in the newly established abortion services and argued over the priorities and characteristics of health care delivery. A broad range of clinics emerged, from feminist clinics to medical offices run by traditional male physicians to for-profit clinics. The establishment of the National Abortion Federation in the mid-1970s created a national forum of health professionals and contributed to the broadening of the discussion and the adoption of compromises as both feminists and physicians influenced each other's practices.

Living through some giant change: the establishment of abortion services.

Unwanted pregnancies can be terminated by either medical or surgical methods. Although both procedures are safe, complications may occur and it is important to inform patients of the potential risks during their pre-operative counselling. The most common complication is the persistence of fetal and/or placental tissue, more rarely the pregnancy may continue. Both patient and operator factors can contribute to the risk of continuing pregnancy. There are a number of precautions that can be taken prior to, or following, the procedure in order to reduce the risk of these rare, but important, complications.

Failed medical and surgical termination of pregnancy

Public health then and now

Living through Some Giant Change

Publisher Summary This chapter discusses using vacuum aspiration for abortion. This procedure varies according to the stage of gestation at which it is being performed. If vacuum aspiration is being done at 4 to 6 menstrual weeks, minimal, if any, cervical dilation is required; soft cannulas will probably be used, along with a minimal amount of rigid instrumentation. If, on the other hand, vacuum aspiration is being done at the 14th to 15th weeks, a greater degree of cervical dilation is required, and possibly multiple insertions of laminaria as well. Aspiration will be limited to removal of blood, amniotic fluid, and placental fragments, augmented by the use of extraction forceps to remove fetal parts that will not pass through a cannula.

Abortion by vacuum aspiration

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Abortion by vacuum aspiration