COMPLICATIONS OF PREGNANCY TERMINATION
Excessive Bleeding
Occasionally very heavy bleeding occurs at the time of the operation and rarely necessitates admission to hospital (1 in 5000 patients.)
Prolonged or troublesome bleeding may occur after termination of pregnancy which requires no specific treatment (1 in 200 patients.).
Retained Products of Conception
This complication occurs due to some
pregnancy tissue remaining after the operation (1 in 200 patients.) This complication can cause heavy to very heavy vaginal bleeding often associated with abdominal cramping. Repeat curettage of the uterus to remove the remaining tissue is usually necessary.
Infection
You will be given a course of antibiotics after the operation to minimise the risk of infection. During the operation the doctor will perform swab test to identify those patients who have a pre-existing infection of the cervix and vagina. In spite of this a small percentage of patients will develop an infection of the uterus and more rarely, of the fallopian tubes (1 in 200 patients.) The symptoms of infection are abdominal pain, fever, offensive vaginal discharge and sometimes increased bleeding. When properly treated your fertility is not impaired.
Uterine Perforation
During the operation one of the instruments used can perforate the wall of the soft, pregnant uterus. This causes a small hole in the wall of the uterus ( 1 in 1000 patients.) Usually this is managed by observation in hospital and is of no consequence. Rarely, a formal operation is needed to repair the uterine wall.
Continuing Pregnancy
Very occasionally, particularly if the operation is done very early in the pregnancy, the pregnancy may not be removed. When necessary we might need you to have blood tests done after the operation to confirm a dropping pregnancy level.
Blockage of the Cervix
This occurs when the cervix heals with some scar tissue, blocking the normal passage from the uterus. This stops the blood from exiting when the next period occurs, usually causing abdominal cramps plus no visible period. This occurs in 1 in 1000 patients. The risk is lower when abortions are performed early in pregnancy (for example at 7 weeks.)
Ectopic Pregnancy
An ectopic pregnancy is one that grows in the fallopian tubes and not in the uterus. This occurs approximately 1 in 200 pregnancies. At termination, no pregnancy tissue will be obtained, alerting the doctor to the possibility of the pregnancy being “ectopic.” Often this might be detected before the operation by the ultrasound. If an ectopic pregnancy is suspected you will need to undergo further investigation and will require admission to hospital for treatment.
An ectopic pregnancy occurs from the time you fall pregnant but the risk increases with time as the pregnancy tissue grows. Because the pregnancy is located in the fallopian tubes it damages the tube as it grows. This causes lower abdominal pain. If you experience any severe abdominal pain contact your doctor or emergency department straight away - do not delay treatment !
Emotional Reaction
For a couple of weeks your hormone levels decline but remain in the body. Some women feel a bit up and down during this time. Some people experience emotions of grief, regret, sadness and guilt. Most people feel a sense of relief. These emotions are normal.
Follow up counselling might help you to understand your feelings and maintain your sense of well being.
Negative Psychological Outcome
The most recent data show that women who terminate an unwanted pregnancy are no more likely to experience depression than those who continue the pregnancy.
However it is important to remember however that each person is unique, as is their situation, culture, beliefs and needs.
Those patients with a history of mental illness are more at risk.
Other Complications
These include allergic reactions to anaesthetic agents both the local anaesthetic and the intravenous anaesthetic. This could happen with any sort of operation so it is important for you to give an accurate and full medical history. If your are having an intravenous anaesthetic you must not have anything to eat including milk and fruit drinks for at least 6 hours before your anaesthetic. This is required to reduce the risk of vomiting and serious lung complications.
This list of complications is given to you to read not to alarm you but to make sure that you are aware that termination of pregnancy, like any other operation is not always completely straight forward. Only an experienced doctor will be performing your operation and every care is taken to minimise the complication rate.
It is important that you attend for a post operative check up two weeks after the operation. This can be with your local doctor.