Follow-up of Patients After Induced Abortion

Follow-up care after all procedures must be ensured. After abortion by all methods, human Rho (D) immune globulin (RhoGAM) should be administered promptly if the patient is Rh-negative, unless it is known that the male partner was Rh-negative. The patient should take her temperature several times daily and report fever or unusual bleeding at once. She should avoid intercourse or the use of tampons or douches for at least 2 weeks. The physician should discuss with the patient the possibility that emotional depression, similar to that following term pregnancy and delivery, may occur after induced abortion. Follow-up care should include pelvic examination to rule out endo- and parametritis, salpingitis, failure of involution, or continued uterine growth. Finally, effective contraception should be made available according to the patient’s needs and desires.

Long-Term Sequelae of Induced Abortion
A large number of studies have been conducted during the past 2 decades to examine the possible long-term sequelae of elective induced abortion. Most of the attention has focused on subsequent reproductive function; unfortunately, many of the studies have had inherent biases and serious methodologic flaws. Despite these problems, enough information is available to provide relative estimates of potential risks. Data from some studies suggest that midtrimester pregnancy loss is more common in women who have undergone 2 or more induced or spontaneous abortions. However, women who have undergone one procedure have essentially the same risk as women who have experienced a single term pregnancy. Regarding low birthweight, only women who have undergone a first-trimester procedure by sharp curettage under general anesthesia appear to have increased risks. The reason for this association might be related to the method of dilatation used. Finally, studies that have examined both ectopic pregnancy and infertility have failed to show any consistent association between these adverse events and prior induced abortion.

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Contraception
Methods of contraception

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Revision date: June 21, 2011
Last revised: by Andrew G. Epstein, M.D.