PE Risk after Induced Abortion

    NextPrevious

    PE Risk after Induced Abortion

    It’s well known that the risk of venous thromboembolism is increased during pregnancy.  It is thought to be two-to-six times higher than the risk in non-pregnant women.  However, these risk estimates are based on pregnant populations that go on to deliver a baby.  Last year Ray et al. published a paper describing their findings on the unique risk of venous thromboembolism that exists after induced abortion.

    The investigators identified 176,000 primigravid women whose first pregnancy ended in induced abortion and matched them with other women whose first pregnancy ended in delivery.  They were also matched with non-pregnant controls.  The primary outcome was any VTE within 42 days of abortion or delivery.  They found that the risk was 30.1 per 100,000 after induced abortion, 184 per 100,000 after delivery, and 13.5 per 100,000 in the non pregnant group.  In other words, induced abortion carries double the risk than that of non-pregnancy, but remains significantly lower than after a livebirth.

    The risk of PE was 21 per 100,000 in the abortion group, and 125 in the livebirth group.  There was no measurement or report of mortality in this study.  However, we can look to the work by Greise et al. in 1978 which suggested that fatal PE is thought to occur in at least 1 out of every 350,000 women undergoing legal abortion (NOTE: this figure says nothing about temporality).

    The implications of these findings are rather significant given that an estimated 25% of pregnancies worldwide end in abortion.

    References:

    Liu N, Vigod SN, Farrugia MM, Urquia ML, Ray JG. Venous thromboembolism after induced abortion: a population-based, propensity-score-matched cohort study in Canada. Lancet Haematol. 2018;5(7):e279-e288.

    Greiss FC Jr: Deaths caused by pulmonary thromboembolism after legally induced abortion. Discussion. Am J Obstet Gynecol 132:173, 1978

    • Welcome! This is the website for the Mount Sinai Emergency Ultrasound Division. It serves as an information resource for residents, fellows, medical students and others seeking information about point-of-care ultrasound. There is a lot ofRead more

    • E-point Septal Separation in the Patient with Congestive Heart Failure

      Perhaps never explained so clearly, Cisewki and Alerhand’s article on EPSS is a wonderful read. Bottom line to remember: EPSS > 7 mm was 87% sensitive and 75% specific at identifying reduced EF (<50%).  This isRead more

    • Lidocaine for cough?

      Whether it’s asthma, a U.R.I., or post nasal drip as the cause, cough is a common enough complaint encountered by emergency physicians everywhere. Of course you must always rule out the dangerous causes of coughRead more

    • Measles redux!

      A quick search of sinaiem.org for the keyword measles brings up a solitary post from 2015, and it’s not actually about measles. With all the attention that measles has been getting in the news recently,Read more

    • The Apple Watch Heart Study

      Disclosure: I’m a huge Apple Fan. Unless you’ve been living under a rock, you’ve heard about the Apple watch, many of you reading this are wearing one right now. On April 24th, 2015 it joinedRead more

    • Peritonsillar Abscess I&D…Can you ditch the endocavitary probe?

      Today’s post is inspired by real-life events and comes with a video (consent given by the patient and providers). The case: 29M presents with dysphonia, odynophagia, and drooling. He is hypertensive, with a low-grade fever,Read more

    • Look into my seeing EYE ball

      THE EYE EXAM Keep it basic… APD Intra-ocular Pressures: Tono-pen v Applanator (Goldmann) Visual Acuity or be a Slit Lamp KWEEN Move outside in: Lids → Eyeball Lids: ducts, eyelashes, orbital lesions or findings EYE:Read more

    • Oh no baby WHAT IS U DOIN’?

      Neonatal Resuscitation. (Some descriptors for reference: Terrifying. Scary. Fear-inducing. Horrific. Chilling.) But fear not! Your TR pearl today is brought to you by the NICU rotation + Jillian Nickerson/T.Webb doing some excellent preparatory work for/withRead more

    • Amanita Muscaria

      For those of you who remember Super Mario Bros… how awesome was it to gobble up that red and white mushroom gliding along the ground and get huge for a few seconds? The result of consuming thisRead more

    NextPrevious