title: Safety of first-trimester uterine evacuation in the outpatient setting for women with common chronic conditions.
abstract: OBJECTIVE
  We compared complications of outpatient first-trimester uterine evacuation between women with medical comorbidities and healthy peers.
  
  
  METHODS
  We examined the medical histories and procedure outcomes of women receiving first-trimester uterine evacuations between 01/02/2009 and 03/07/2014. We compared women without medical problems to those reporting diabetes, hypertension, obesity (body mass index ≥30.0 or weight ≥200 lbs), HIV, epilepsy, asthma, thyroid disease and/or bleeding/clotting disorders. We compared incidence of any of the following: resuction, uterine perforation, estimated blood loss >100 cc and cervical laceration.
  
  
  RESULTS
  A total of 1960 women met inclusion criteria; 597 (30%) had ≥1 comorbidity. When compared to women without medical morbidities, women with common chronic conditions were older (28.3±6.7 vs. 27.3±6.7 years, p<.01), less likely to be primigravid (29.1% vs. 35.7%, p<.01) and more likely to have had a prior cesarean delivery (24.9% vs. 15.7%, p<.001). Gestational age and indication for evacuation were similar for the groups. The overall complication rate was 2.9%. There was no difference in complications between the group of patients with at least one comorbidity compared to the group of women without any comorbidity (OR=0.9, 95% CI 0.5, 1.6). Additionally, there were no specific medical comorbidities that led to an increased complication rate. The only significant predictor of complication was history of cesarean delivery (OR=1.9, 95% CI 1.1, 3.4).
  
  
  CONCLUSIONS
  Women with common chronic conditions undergoing outpatient first-trimester uterine evacuation do not appear to be at greater risk of complications compared to healthy peers. While a careful medical history is always required, providers may feel reassured that complications remain infrequent.
  
  
  CONCLUSIONS
  Women with common chronic conditions undergoing outpatient first-trimester uterine evacuation do not appear to be at greater risk of complications compared to healthy peers.
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave Room 4203, Mailstop B192-2, Aurora, CO 80045, USA. Electronic address: Maryam.guiahi@ucdenver.edu.
authors.forename: Maryam
authors.initials: M
authors.lastname: Guiahi
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave Room 4203, Mailstop B192-2, Aurora, CO 80045, USA.
authors.forename: Georgia
authors.initials: G
authors.lastname: Schiller
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave Room 4203, Mailstop B192-2, Aurora, CO 80045, USA.
authors.forename: Jeanelle
authors.initials: J
authors.lastname: Sheeder
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave Room 4203, Mailstop B192-2, Aurora, CO 80045, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Teal
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects* / Q000379:methods; D000328:Adult; D000367:Age Factors; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods; D002585:Cesarean Section / Q000009:adverse effects; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D064368:Healthy Volunteers; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000601:surgery*; D011261:Pregnancy Trimester, First
keywords: Abortion care; Complications; First-trimester; Medical comorbidities