Hysterotomy abortion

Hysterotomy abortion is a surgical procedure that removes an intact fetus from the uterus in a process similar to a cesarean section. The procedure is generally used after the failure of another method, or when such a procedure would be medically inadvisable, such as in the case of placenta accreta.[1]

Hysterotomy abortion
Background
Abortion typeSurgical
First use<1913
Gestation2nd Trimester and Later
Usage
U.S. figures include both hysterotomy and hysterectomy.
United States<0.01% (2016)
Infobox references

In 2016, this method made up less than 0.01% of all abortions in the United States, with the CDC reporting only 51 having occurred due to the invasive and complex nature of the procedure, and the availability of much simpler and safer methods.[2]

Indications

As with other abortion procedures, the purpose of a hysterotomy abortion is to end a pregnancy by removing the fetus and placenta. This method is the most dangerous of any abortion procedure, and has the highest complication rate.[1]

Procedure

Hysterotomy is major abdominal surgery; it is generally only performed in hospitals and other advanced practice settings. The procedure is nearly identical to a cesarean section, with two main exceptions: the administration of a feticidal injection of digoxin or potassium chloride before the procedure to ensure fetal demise, guaranteeing compliance with various laws on the subject, and preventing an unintended live birth; and the size of the incision, which is generally smaller than that of a cesarean section, as the fetus is generally not full term.

History

Scholarly sources place the use of this method since at least 1913.[3] Health officials in the United States warned practitioners against performing hysterotomy abortion in an outpatient setting after it led to the deaths of two women in New York during 1971.[4][5] The rate of mortality of abortion by hysterotomy and hysterectomy reported in the United States between 1972 and 1981 was 60 per 100,000, or 0.06%.[6]

References
  1. Roche, Natalie E. (June 16, 2006). Surgical Management of Abortion. Retrieved July 1, 2007.
  2. Jatlaoui, Tara C. (2019). "Abortion Surveillance — United States, 2016". MMWR. Surveillance Summaries. 68 (11): 1–41. doi:10.15585/mmwr.ss6811a1. ISSN 1546-0738. PMID 31774741.
  3. Bonney, Victor (October 1918). "On Abdominal Evacuation of the Pregnant Uterus Before Viability". The Lancet. 192 (4964): 518. doi:10.1016/s0140-6736(01)02878-1. ISSN 0140-6736.
  4. Berger GS, Tietze C, Pakter J, Katz SH (March 1974). "Maternal mortality associated with legal abortion in New York State: July 1, 1970--June 30, 1972". Obstet Gynecol. 43 (3): 315–26. PMID 4814448.
  5. Stroh G, Katz SH, Hinman AR (October 1975). "Performing second-trimester abortions. Rationale for inpatient basis". N Y State J Med. 75 (12): 2168–71. PMID 1059921.
  6. Grimes DA, Schulz KF (July 1985). "Morbidity and mortality from second-trimester abortions". J Reprod Med. 30 (7): 505–14. PMID 3897528.


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