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Evaluation of 496 menstrual regulation and abortion patients in Calcutta.

From March to December 1975, 496 patients were studied to compare the safety and effectiveness of menstrual regulation (MR) performed with a Karman hand syringe and first trimester abortion performed with an electric vacuum aspirator. All procedures were done on an outpatient basis. The complication rate for the MR patients was significantly lower than that for the other first trimester abortion patients. Study results indicate that MR with the Karman syringe is a safer, simpler and less costly procedure than first trimester abortion with the electric vacuum aspirator. Further research and study are necessary to determine the effect of the initial and repeat MR procedures on women's menstrual patterns and future pregnancies, including any subsequent prematurity, stillbirths and Rh immunization.

Abortion, Induced↗

Menstrual regulation as a method for early termination of pregnancy.

116 women with documented or suspected pregnancy underwent an endometrial aspiration for early termination. Their menses delay was between 7 and 22 days. A standard 3 mm Vabra aspirator was used. 90.5% were actually pregnant. The success rate was 97.1%. The total complication rate was 6.8%, the most common complication being endometritis. Three patients required a re-evacuation because of prolonged bleeding. In this series there were two ectopic pregnancies and nine cases of ovum abortivum, of which one later turned out to be a hydatiform mole. The procedure was well tolerated by the patients. No sick-leave was given. The postoperative bleeding averaged 10 days in primigravid and 7 days in parous patients.

Abortion, Induced↗

Early pregnancy termination: an improved technique for 'menstrual regulation' with ultrasound assistance.

We performed aspiration of early pregnancy on 100 women requesting termination, using a low caliber angled catheter under sonographic guidance, without analgesia or anesthesia. The sonographic inclusion criteria for the study were: (1) mean gestational sac diameter less than 30 mm, or (2) crown rump length less than 10 mm when an embryo was visualized. The uterine content was successfully evacuated in all cases and none needed an additional curettage. Two women developed mild endometritis which responded to antibiotic therapy. This refinement of this 'menstrual regulation' technique seems to be safer when compared with the reported results of the original technique.

Abortion, Induced↗

Regulating menstrual bleeding. A prime function of progesterone.

Progesterone plays a crucial role in the coordination of endometrial breakdown as well as in the determination and regulation of menstrual blood loss and endometrial transudation of fluid. Furthermore, long-term exposure of the endometrium to progesterone can result in abnormal angiogenesis. Although additional investigations of the estrogen-progesterone relationship are needed, the relative concentrations of these two hormones appear to have important effects on bleeding patterns. Current research is aimed at greater understanding of the ways in which these two hormones interact with several complex cellular and metabolic mechanisms to regulate endometrial bleeding.

Endometrium↗

Maternal and public health benefits of menstrual regulation in Chittagong.

In Bangladesh abortions induced by untrained traditional birth attendants cause high levels of morbidity and mortality. A 2-year program was initiated to provide early atraumatic termination of pregnancy at Chittagong Medical College Hospital on an outpatient basis. The effect of the program on hospital admissions for septic induced abortion was studied by reviewing hospital records. In 2 years hospital admission for induced abortion decreased by 72%, and bed days used for treatment of induced abortion declined by 75%. Deaths occurring in the hospital that were attributed to induced abortion remained at a low level but were not eliminated.

Abortion, Induced↗

Menstrual regulation in the United States: a preliminary report.

The efficacy and safety of vacuum aspiration on an outpatient basis without anesthesia or cervical dilatation within 14 days of a missed menstrual period was evaluated in 1,009 women. Among those patients in whom pregnancy could be documented (54.8%), 4.2% were still pregnant after the procedure. Potentially serious complications were pelvic infection (0.4%), bleeding requiring a repeat curettage (0.3%), and prolonged bleeding (0.7%). For comfort, 26.7% received local anesthesia or analgesia. To allow selection of a higher proportion of pregnant patients, the probability of pregnancy was derived for patients with either a positive or negative pregnancy test at each length of amenorrhea. To determine the best vacuum pressure and source, and the cannula size and type at each duration of pregnancy, a more extensive (large, controlled, comparative) study is required.

Abortion, Induced↗