CAUSATIVE FACTORS IN FIRST TRIMESTER ABORTION FAILURE

Objective: To evaluate the main contributors to failed first timester abortions. Patients and design: Forty-two cases of unintentional conti nued pregnancy were detected among 23 000 termination procedures perfo rmed between 1989 and 1995. The patients were diagnosed either at foll ow-up visits or at the time of operation due to abnormal pelvic findin gs or discrepancy between the expected and obtained tissue. Results: T he failure rate was found to be 0.18%. Among the patients with failed abortion 8 patients had unsuspected anomalies; two of these patients c onceived with an intrauterine device in position; 7 patients had uteri ne malposition (2 markedly anteverted and 5 markedly retroverted), and 2 patients had leiomyomas. No genital disorder was identified in the remaining 25 women. Among these 25 women, 10 had gestations beyond 8 w eeks, for which suction curettage followed by sharp curettage was perf ormed. Among the remaining 15 in whom only suction curettage was used for termination, 13 had less than 6 weeks of gestation at the time of pregnancy termination. Conclusion: When a termination fails, when scan ty tissue is obtained, or when doubt exists about the termination, an extrauterine pregnancy must be ruled out and other causes of terminati on failure should be considered such as technical failure, uterine ano maly, or malposition.