Karman cannula를 사용한 조기 임신중절에 관한 임상적 연구

Abstract

Karman cannula. a flexible polyethylene catheter for vacuum aspiration of early pregnancies, was first described in 1970 by Harry Karman. The advantages of this cannula were said to be that of easy and painless introduction into the pregnant uterus without dilatation or anesthesia. and prevention of uterine perforation due to its flexibility. The present study is undertaken to evaluate the safety and effectiveness of Karman cannula for the purpose of induced abortion up to 12 weeks of gestation and to analyze the sociodemographic characteristics and fertility profile of the patients. A total of 2140 cases were terminated at the Family Health Clinic of Seoul National University, School of Medicine, from February I. 1974 to December 31, 1975. The obtained results are as follows: 1. The median age was 32. 8 years and median number of living children was 3. 1. Two third of the patients were between 30 and 39 years of age and had 2 to 3 living children. 2. Regarding their education level. 57% of them had graduated high school or college. 3. More than half of the patients responded that their ideal number of children was three. 4. Among the patients 6 weeks or less from LMP. composing 47.7% of all patients, 15.3% were proved non-pregnant macroscopically. 5. During the procedure. anesthesia was not needed in the majority of cases and trilene inhalation was needed in 5.3% of the total. 6. Exploring curettage immediate after uterine aspiration revealed that aspiration was complete in more than 88% of the patients 7 weeks or less from LMP, however, it was incomplete in 29.8% of 8weeks group and 47.2% of 9-12 weeks group. Therefore, it was suggested that the use of Karman cannula in the termination of pregnancy up to 7 weeks was simple, safe, effective and acceptable procedure. 7. Overall complication rate was 4.5%. This includes 0.4% of cervical injury caused by toothed tena culum, 1.3% of vomiting, 0.3% of faintness, 1 case of uterine perforation caused by post aspiration metal curettage during the procedure. Besides 1.0% of mild pelvic infection, 1. 1% of persistant bleeding, 0.3% of retained product of conception, and 2 cases of ectopic pregnancies were also included.