Journal of Ultrasound in Medicine, Vol 8, Issue 2 71-75, Copyright © 1989 by American Institute of Ultrasound in Medicine
Routine intraoperative ultrasonography for second trimester abortion reduces incidence of uterine perforation
P. D. Darney and R. L. Sweet
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco.
Second trimester elective abortion is safest when accomplished with
cervical dilation and instrumental uterine evacuation (D and E), but this
procedure carries with it a risk of uterine perforation and possible
intra-abdominal trauma. In order to determine if the routine use of
intraoperative ultrasonography reduces the risk of this feared and serious
complication, 353 elective abortions at 16 to 24 weeks gestation performed
without sonography were compared to 457 in which sonography was routinely
employed. All 810 operations were carried out in one clinic using the same
operative technique. The routine intraoperative use of ultrasonographic
imaging to guide intrauterine forceps during uterine evacuation for second
trimester elective abortion resulted in a significant reduction in uterine
perforation, the rate declining from 1.4% to .2%. These findings support
the routine use of intraoperative ultrasonography for second trimester
elective abortion to reduce the incidence of uterine perforation and make
the procedure a safer one.
