King's Termination Study II: Contraceptive Practice before and after Outpatient Termination of Pregnancy

A selection of psychological and social factors present in 360 women who underwent legal termination of pregnancy are related to their contraceptive practice. One-third of the group were ignorant about contraceptive methods, ignorance being more common in women from social classes IV and V and in those under the age of 19. Nearly half of those who had some knowledge of contraceptive practice became pregnant after knowingly taking a risk. A total of 41% had been using some form of contraception immediately before conception. The reliability of contraceptive methods used was found to be inversely related to neuroticism scores obtained from the Eysenck Personality Inventory, neuroticism being highest in women who had not used any form of contraception.Of 91% of the group seen three months after their termination 86% were using reliable contraceptive methods. A follow-up study one or two years after termination has shown that 81% of the 215 women contacted so far are using a reliable method of contraception; two unwanted pregnancies have occurred but both were due to contraceptive failure. This satisfactory outcome has been ascribed to the system of counselling all women before and after termination.     

Rubella Vaccination and Termination of Pregnancy

Six terminations of pregnancy have been carried out in Leicestershire since February 1970 because of rubella vaccine administered inadvertently during early unrecognized pregnancy. Any woman of child bearing age shown by serological tests to be susceptible to rubella should be offered vaccination, preceded and followed by adequate contraception.     

Termination of Pregnancy with Intra-amniotic Hypertonic Saline

Successful therapeutic abortion was performed consecutively by an intra-amniotic injection of hypertonic saline in 102 out of 110 patients in whom the size of the uterus corresponded with a pregnancy of 16 weeks or more.A spontaneous abortion of the fetus followed the injection alone in 92 of the cases, and the overall injection-delivery interval was 39·75 (range 11-98) hours. In 10 women intravenous oxytocin injection was used as an additional uterine stimulant because contractions were not established after 48 hours. Complete spontaneous expulsion of the placenta occurred in 71 cases, and evacuation of the placenta under general anaesthesia was required in the other 31.No major complication occurred among the 110 patients.     

Outpatient Termination of Early Pregnancies Using Syringe and Plastic Cannula

Using a 50 ml syringe and a Karman-type cannula-curette, outpatient therapeutic abortions were done in 543 women who were not more than eight weeks pregnant. All patients received paracervical block analgesia and atropine was given intravenously to minimize vagal reactions. In five women (0.9 percent) pregnancies were missed by the procedure, and in 13 women (2.4 percent) abortions were incomplete. In only one patient did a significant postoperative pelvic infection occur. Twenty-seven women (4.9 percent) were not pregnant; the initiation of routine urine pregnancy testing reduced the percentage of those who were nongravid. The procedure using syringe and plastic cannula is safe, well tolerated and has reduced therapeutic abortion costs.     

Some Operative and Postoperative Hazards of Legal Termination of Pregnancy

Analysis of 1,317 patients admitted for N.H.S. abortion showed an overall morbidity of 16·8% excluding urinary tract infection. Genital infection, chest infection, reevacuation or perforation of the uterus, and haemorrhage were the more common complications. There was one maternal death.     

Hospital Family Planning: Termination of Pregnancy and Contraceptive Use

A review of termination of pregnancy in a district hospital catchment area for 1970 to 1972 shows how a decrease in total numbers of terminations and repeat terminations may be effected by the use of intensive family planning. In 1972 over 80% had first trimester abortions, but most of the second trimester abortions came from the manual skilled, semi-skilled, and unskilled occupational groups. Over half those attending for termination had never used any method of contraception. Acceptance of family planning after termination was high but motivation poor, emphasizing the suitability of intrauterine devices inserted at the time of termination. The complication rate after termination was low.