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Overview of pregnancy termination

Author
Jody Steinauer, MD, MAS
Section Editor
Robert L Barbieri, MD
Deputy Editor
Sandy J Falk, MD, FACOG

INTRODUCTION

Uterine evacuation is an integral part of obstetric and gynecologic care, not only for elective pregnancy termination, but also in the management of spontaneous abortion, intrauterine fetal demise, retained products of conception, and gestational trophoblastic neoplasia. The choice of technique for uterine evacuation depends more upon uterine volume and operator experience than the underlying indication for the procedure.

Issues common to both first and second trimester pregnancy termination will be reviewed here. Techniques for first and second trimester procedures are discussed separately. (See "Surgical termination of pregnancy: First trimester" and "Overview of second-trimester pregnancy termination".)

EPIDEMIOLOGY

According to the Centers for Disease Control (CDC), the rate of pregnancy termination in the United States in 2008 was 16 per 1000 women aged 15 to 44 years, or 234 per 1000 live births; there was a 4 percent decrease in the rate of abortions from 1999 [1]. The CDC figures are based upon data voluntarily reported to state health agencies and are incomplete. The Alan Guttmacher Institute, which surveys all known abortion providers, reported a rate of 19 abortions per 1000 women in 2008 [2].

The estimated worldwide rate for abortion in 2008 was 28 per 1000 women ages 15 to 44 [3]; the highest rate was in Eastern Europe (43 per 1000) and the lowest rate was in Western Europe (12 per 1000). Forty-nine percent of abortions were classified as "unsafe" (generally referring to illegal procedures), compared with 45 percent in 1995. Unsafe abortions occurred mostly in developing countries; the rate of unsafe abortion in Africa was 97 percent and in south central Asia was 65 percent.

In the United States in 2008, there were 6.4 million pregnancies among 62 million women. Fifty percent of pregnancies were unintended and 19 percent of pregnancies resulted in pregnancy termination [2]. In England in 2010, there were 225,600 unintended pregnancies and 155,500 induced abortions [4].

                                       

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Literature review current through: Nov 2016. | This topic last updated: Tue Jul 26 00:00:00 GMT+00:00 2016.
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