Coagulopathy and induced abortion methods: rates and relative risks

Am J Obstet Gynecol. 1983 Oct 1;147(3):344-5. doi: 10.1016/0002-9378(83)91128-6.


PIP: The relative risks of coagulopathy from suction curettage, dilatation and evacuation (D and E), and saline instillation were examined using the records of all women obtaining abortions at the Inglewood Hospital in California from February 1980-September 1981. Abortion-related coagulopathy cases were defined as those having both clinical evidence of nonclotting hemorrhage and laboratory confirmation of lower than expected fibrinogen levels (200 mg/dl). During the study period, 13,272 abortions were done by suction curettage, 2619 by D and E, and 304 by saline instillation. 8 cases of coagulopathy were identified. 1 case was associated with suction curettage, 2 with saline instillation, and 5 with D and E. The rates for coagulopathy/100,000 procedures were 8 for suction curettage, 191 for D and E, and 658 for saline instillation. Compared with that of suction curettage, the relative risk of coagulopathy associated with D and E was 25 and of saline instillation, 87, both statistically significant. The relative risk associated with saline instillation versus D and E was 3.4, not statistically significant. The study presents the experience of a single institution with a single group of similarly trained physicians, and uses uniform diagnostic criteria for coagulopathy, but the findings were based on the experience of a limited patient population and the demographic characteristics of the 16,195 women were unavailable, so that potential confounders such as age and parity could not be controlled. Large series are required to define more precisely the risk of coagulopathy for the various abortion methods.

MeSH terms

  • Abortion, Induced / adverse effects*
  • Abortion, Induced / methods
  • Disseminated Intravascular Coagulation / epidemiology
  • Disseminated Intravascular Coagulation / etiology*
  • Female
  • Humans
  • Pregnancy
  • Risk