Darney P D, Sweet R L
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco.
J Ultrasound Med. 1989 Feb;8(2):71-5. doi: 10.7863/jum.1989.8.2.71.
Second trimester elective abortion is safest when accomplished with cervical dilation and instrumental uterine evacuation (D and E), but this procedure carries with it a risk of uterine perforation and possible intra-abdominal trauma. In order to determine if the routine use of intraoperative ultrasonography reduces the risk of this feared and serious complication, 353 elective abortions at 16 to 24 weeks gestation performed without sonography were compared to 457 in which sonography was routinely employed. All 810 operations were carried out in one clinic using the same operative technique. The routine intraoperative use of ultrasonographic imaging to guide intrauterine forceps during uterine evacuation for second trimester elective abortion resulted in a significant reduction in uterine perforation, the rate declining from 1.4% to .2%. These findings support the routine use of intraoperative ultrasonography for second trimester elective abortion to reduce the incidence of uterine perforation and make the procedure a safer one.
孕中期选择性流产在通过宫颈扩张和器械性子宫排空术（D和E）完成时最为安全，但该手术存在子宫穿孔和可能的腹腔内创伤风险。为了确定术中超声检查的常规使用是否能降低这种可怕且严重并发症的风险，将353例在妊娠16至24周时未进行超声检查的选择性流产与457例常规使用超声检查的病例进行了比较。所有810例手术均在一家诊所采用相同的手术技术进行。在孕中期选择性流产的子宫排空过程中，常规术中使用超声成像来引导宫内钳，子宫穿孔率显著降低，从1.4%降至0.2%。这些发现支持在孕中期选择性流产中常规使用术中超声检查以降低子宫穿孔的发生率，并使该手术更安全。
