Medical versus surgical termination of pregnancy in primigravid women—is the next delivery differently at risk? A population-based register study
Article first published online: 6 NOV 2012
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 120, Issue 3, pages 331–337, February 2013
How to Cite
Medical versus surgical termination of pregnancy in primigravid women—is the next delivery differently at risk? A population-based register study. BJOG 2013;120:331–337., , , , , , .
- Issue published online: 14 JAN 2013
- Article first published online: 6 NOV 2012
- Manuscript Accepted: 19 SEP 2012
- Low birthweight;
- placental complication;
- preterm birth;
- small-for-gestational age;
- termination of pregnancy
To compare the effect of medical versus surgical termination of pregnancy (TOP), performed in primigravid women, on subsequent delivery.
Population-based register study.
All primigravid women (n = 8294) who underwent TOP during first trimester of pregnancy by medical (n = 3441) or surgical (n = 4853) method, and whose subsequent pregnancy resulted in singleton delivery.
The women were identified in the Finnish Register of Induced Abortions, and the data were linked to the Medical Birth and the Hospital Discharge Registries.
Main outcome measures
Risk of preterm birth, low birthweight, small-for-gestational-age (SGA) infant and placental complications (placenta praevia, placental abruption, retained placenta, placenta accreta).
No statistically significant differences in the incidences of preterm birth (4.0% in the medical group versus 4.9% in the surgical group), low birthweight (3.4% versus 4.0%), SGA infants (2.6% versus 2.9%) or placental complications (2.6% versus 2.8%) emerged between the two groups. After adjusting for various background factors, medical TOP was not associated with significantly altered risks of preterm birth (odds ratio [OR] 0.87, 95% confidence interval [95% CI] 0.68–1.13), low birthweight (OR 0.90, 95% CI 0.68–1.19), SGA infant (OR 0.87, 95% CI 0.64–1.20) or placental complications (OR 0.98, 95% CI 0.72–1.34) versus surgical TOP. In a sub-analysis excluding women who underwent surgical evacuation following the index TOP, medical TOP was associated with a reduced risk of preterm birth (P < 0.01), but the difference became insignificant after adjusting for gestational age at the time of TOP, inter-pregnancy interval, maternal age, cohabitation status, socio-economic status, residence and smoking during pregnancy.
A history of one medical versus surgical TOP, performed in primigravid women, is associated with similar obstetric risks in the subsequent delivery.