title: Safety of induced abortions at less than 12 weeks of pregnancy in Japan.
abstract: OBJECTIVE
  To assess the safety of various methods of induced abortion when used before 12 weeks of pregnancy in Japan.
  
  
  METHODS
  A retrospective study was undertaken of induced abortions conducted between January 1 and December 31, 2012. Questionnaires were sent to 4154 institutions that employed doctors who were licensed to conduct induced abortions. Information was obtained about the numbers of induced abortions performed before 12 weeks, methods, complications, and routine management.
  
  
  RESULTS
  Completed questionnaires from 2434 institutions showed that 100 851 induced abortions had been performed. Vacuum aspiration (VA) was used in 20 458 (20.3%) abortions, VA with sharp curettage in 47 148 (46.8%), dilatation and curettage (D&C) in 32 958 (32.7%), and medical abortion in 287 (0.3%). Overall, 358 complications were reported (355.0 per 100000 procedures). The rate of complications was significantly higher after D&C than after VA and after VA with sharp curettage (P<0.001 for both). However, incomplete abortion requiring repeat procedures was the only complication that was significantly associated with D&C (P<0.001).
  
  
  CONCLUSIONS
  D&C can be safely used for induced abortion before 12 weeks of pregnancy, but changing from D&C to VA could reduce incomplete abortions and improve the safety of induced abortions before 12 weeks of pregnancy in Japan.
authors.affiliation: Department of Obstetrics and Gynecology, Nippon Medical School, Tama Nagayama Hospital, Tokyo, Japan. Electronic address: oya-a@nms.ac.jp.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Sekiguchi
authors.affiliation: Department of Obstetrics and Gynecology, Mie University, Mie, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
authors.affiliation: Department of Obstetrics and Gynecology, Tohoku Kosai Hospital, Miyagi, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Okamura
authors.affiliation: Department of Obstetrics and Gynecology, Nippon Medical School, Tama Nagayama Hospital, Tokyo, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Nakai
mesh_terms: D000027:Abortion, Incomplete; D000028:Abortion, Induced / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D004107:Dilatation and Curettage / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007564:Japan; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D012449:Safety
keywords: Complication; Dilatation and curettage; First trimester; Incomplete abortion; Induced abortion; Medical abortion; Sharp curettage; Vacuum aspiration