title: Clinical, surgical, and histopathologic outcomes following failed medical abortion.
abstract: OBJECTIVE
  To address the consequences of surgical curettage following failed medical abortion.
  
  
  METHODS
  A retrospective case-control study was performed in a tertiary gynecologic department. The case group comprised 104 women who underwent surgical curettage following failed medical abortion; the control group included 104 women who underwent early surgically induced abortion. Clinical characteristics and surgical findings were examined. The extent of inflammation was quantified following immunohistochemical staining for cell-surface markers characteristic of T lymphocytes, B lymphocytes, and macrophages. The extent of necrosis was evaluated morphologically.
  
  
  RESULTS
  Abnormal findings during surgical curettage were significantly more prevalent among women in the case group than in the control group (10.6% versus 1.9%; P=0.019). The most frequent abnormality in the case group was the presence of intimately adherent products of conception, necessitating sharp curettage. The extent of inflammation (represented by increased numbers of T and B lymphocytes) was greater in the case group than in the control group (P=0.046 and P=0.001, respectively), as was the extent of necrosis (P<0.05).
  
  
  CONCLUSIONS
  Curettage following failed medical abortion harbors particular difficulties, which may be attributed to an inflammatory response. The long-term consequences of curettage following failed medical abortion warrant further investigation.
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel. noga_fuchs@yahoo.com
authors.forename: Noga
authors.initials: N
authors.lastname: Fuchs
authors.forename: Ron
authors.initials: R
authors.lastname: Maymon
authors.forename: Ido
authors.initials: I
authors.lastname: Ben-Ami
authors.forename: Sonia
authors.initials: S
authors.lastname: Mendlovic
authors.forename: David
authors.initials: D
authors.lastname: Schneider
authors.forename: Moty
authors.initials: M
authors.lastname: Pansky
authors.forename: Reuvit
authors.initials: R
authors.lastname: Halperin
mesh_terms: D000028:Abortion, Induced; D015703:Antigens, CD / Q000378:metabolism; D018951:Antigens, CD20 / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D016063:Blood Loss, Surgical; D017252:CD3 Complex / Q000378:metabolism; D016022:Case-Control Studies; D004717:Endometrium / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005333:Fetus / Q000473:pathology; D006801:Humans; D009336:Necrosis; D012189:Retrospective Studies; D017211:Treatment Failure; D014619:Vacuum Curettage / Q000009:adverse effects; D000097382:CD68 Molecule
chemical_list: D015703:Antigens, CD; D018951:Antigens, CD20; D015214:Antigens, Differentiation, Myelomonocytic; D017252:CD3 Complex; C067980:CD68 antigen, human; D000097382:CD68 Molecule