PPA Day Surgeries
Risks Associated with an Abortion Procedure
There are risks associated with every operation and every anaesthetic. With termination of pregnancy (approx 1:100) women will experience some complication from the operation. Minor complications are much more likely than major ones, but complications do occur. At his facility we are only a short distance away from a major public hospital. All our medical and nursing staff are highly skilled in abortion and emergency care. The most common complications are listed below :
Retained Products of Conception: Prolonged bleeding after termination may occur approx 1:100 and may require a repeat curette. This is usually associated with abdominal pain (like period pain), heavy and prolonged bleeding and or passing of clots. This is caused when some tissue has been retained in the uterus.
Infection: A small umber of patients (1:200) will develop an infection of the fallopian tubes or uterus. The symptoms are a temperature over 37.5c, fever, pain and malodorous vaginal discharge. Infection can sometimes cause infertility if not treated.
Perforation of the Uterus : During the operation a small hole or perforation (tear) can occur in the soft lining of the pregnant uterus. The risk of perforation is approx 1:1000. Usually, this will repair itself and observation of the clinic or the hospital is all that is required. Occasionally an operation in hospital would be required to repair a tear in the uterus. Very rarely a hysterectomy (removal of the uterus) may be required.
False Passage: Occasionally a false passage/channel in the cervix can be created, not allowing entry into the uterus.
Excessive bleeding: Occasionally very heavy bleeding can occur at the time of the operation and you may need to be admitted to hospital, approx 1:5000. You may require surgery or a blood transfusion to correct the bleeding. Very rarely, but more so in mid-trimester patients, disseminated intravascular coagulation can occur where the patient’s blood does not clot and the patient needs to be cared for in the intensive care unit of a hospital. This is a life threatening condition.
Clot retention: It is possible to have clot retention in your uterus after your termination of pregnancy. The main symptoms are increasing pain and discomfort with no bleeding. A repeat curette is the usual treatment.
Cervical Stenosis: Approximately 1 in 500 patients will develop a small amount of scar tissue at the opening of the uterus. This stops the blood from leaving the uterus. Usually this is easy to treat and can be done at the clinic. Vary rarely the scar tissue can be more extensive (Aschermann’s Syndrome) and can sometimes cause untreatable infertility.
Continuing Pregnancy: Very occasionally, especially if the pregnancy is very early, it may be missed. If the pregnancy symptoms persist over 1-2 weeks and if you have not had a period in 6 weeks, it is wise to have a repeat ultrasound as soon as possible. A blood pregnancy test can still be positive 5 weeks after a successful termination. If there is still a pregnancy in the place, a second procedure can be performed.
Ectopic Pregnancy: Approximately 1:200 pregnancies will lodge in the fallopian tube and not in the uterus. If a termination is performed, no pregnancy tissue will be obtained. If an ectopic pregnancy is confirmed, then admission to hospital for observation and removal of the pregnancy will be necessary. We have a special information sheet for ectopic pregnancies you will be given to read, if we think you are at risk. Ectopic pregnancies are serious if left untreated and may cause loss of a fallopian tube or death.
Psychological Disturbances: Significant emotional and psychological problems post-operatively are uncommon. They are more likely if a patient has pre-existing psychological problems. If a woman is coerced atainst her will. Long-term counselling can be arranged with a referral to a counselling service.
Death: All surgical procedures carry a risk of death. Anaesthetic risk is of much greater concern than that of the surgery. Throughout the world, the risk of death associated with an abortion procedure in the first trimester is 1:100,000.
Should you require treatment due to a complication, please be aware that additional costs may be incurred.
Please try to keep these risks in perspective. You and your partner are welcome to discuss any worries or questions you may have with your doctors before your procedure.