606 Obstetrics and Gynecology Board Review •••
❍ Which country has the highest abortion rate among all Western nations?
The United States of America.
❍ Suction curettage accounts for what percentage of all abortion procedures?
90%.
❍ What is the predominate method of abortion beyond the first trimester?
Dilatation and evacuation.
❍ Name another method used to induce contractions to perform abortion in the second trimester.
Prostaglandin induction.
❍ What are two important determinants of abortion complication?
Gestational age and method of abortion chosen.
❍ What are the associated causes of hemorrhage after pregnancy termination?
Uterine atony, a low-lying implantation site, a pregnancy of more advanced gestational age, or perforation.
❍ What percentage of pregnancy terminations are done in the first trimester?
In 1990, approximately 88% were done in the first trimester, 11% between 13 and 20 weeks, and 1% were done at
21 weeks or greater.
❍ Which groups of medical agents have been found extremely useful for pregnancy termination?
Prostaglandin E2 (dinoprostone) and prostaglandin E1 (misoprostol) as well as the antiprogestin RU 486
(mifepristone) and the antimetabolite methotrexate have been very useful for this purpose.
❍ RU 486 is an analogue of which steroid used frequently in oral contraceptive pill formulations?
Norethindrone.
❍ Under what conditions is hysterotomy indicated?
Failed abortion when uterine anomaly is suspected.
❍ Which landmark Supreme Court decision concludes that the state may not interfere with the practice of
abortion in the first trimester?
Roe v. Wade.
❍ What percentage of abortions are obtained by married women?
25%.
❍ What effect does laminaria japonicum have on the morbidity associated with forcible dilation during D&E?
Fivefold reduction in cervical laceration.