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[Complications of voluntary interruption of pregnancy].


 Although the legalization of abortion has almost eliminated the risk of mortality, the experience is still psychologically difficult for many women, increasing the need for sympathetic treatment by the staff. Intraoperative complications may result from regurgitation, cardiovascular irregularities, or allergic reaction caused by the general anesthesia usually employed; from uterine perforation by the operative instruments, most commonly among multiparas and women who have undergone cesareans or have a uterine infection; or uterine hemorrhage. Uterine perforation is usually evaluated by celioscopy and may require surgical intervention if bleeding occurs. Infection and peritonitis may result from perforation. Complications of anesthesia may be reduced by using local anesthetic, while complications of uterine perforation may be reduced by careful examination of the patient under general anesthesia before the procedure begins. In the event that no products of conception are recovered, the instruments must be checked for malfunction, evidence of pregnancy should be reexamined, and ectopic pregnancy ruled out through clinical examination and celioscopy. Immediate postoperative complications may include uterine or tubal infection caused by retention of debris or perforation, peritonitis, and septicemia, and can result in secondary sterility. Continuation of the pregnancy is a rare complication. Late complications may include sterility due to cervico-isthmal weakening, uterine synechia, tubal occlusion, or psychological factors.
