Uterine perforation following medical termination of pregnancy by vacuum aspiration.

Out of 9344 first trimester elective abortions performed by vacuum aspiration, 37 uterine perforation cases occurred. The suction cannula was responsible for more than 50% of perforations. All cases were multiparous. In 56.8%, the duration of gestation was 6 weeks or less. One third of the cases had a history of child birth within the previous 6 months. Fundal and anterior wall perforations were most common. Cases with a retroverted uterus had a higher incidence of perforation (59.4%) than those with an anteverted uterus (32.4%). Exact pelvic assessment and proper technique and case management are important for preventing perforation.