Menstrual induction: its place in clinical practice.

221 patients who underwent menstrual induction (MI) in the privates offices of a University Medical Faculty Group located in a hospital with ready access to operating room facilities. Histologic examination of tissue removed was consistent with a diagnosis of pregnancy in 98.2%. Most studies suggest that when MI is performed before Day 7 of amenorrhea about 50% of the women are pregnant; when done between Days 7 and 14 about 85% are pregnant. For this reason patients selected were: a) free of significant medical disease; b) were 7-21 days beyond expected occurrence of a menstrual period; c) believed pregnancy was pos sible or probable; and d) had a positive urine pregnancy test. An office slide test for urinary human chorionic gonadotropin was used as a screening test to avoid unnecessary procedures. When assured an unwanted conception would be removed most women were willing to be retested 1 week later. When pregnancy was not confirmed the patient was evaluated for secondary amenorrhea. Patients were given an analgesic 1/2 hour before MI a paracervical block was used a nonperforating tenaculum was used to grasp the cervix and following a uterine sound aspiration was done with a 5 or 6 mm flexible plastic cannula connected to an electric suction machine. Patients were requested to wait in the waiting room 1 hour after the procedure. In only 2 patients was anxiety sufficient to perform MI when the slide test was negative. Major complications attributable to the procedure were: 2 cases of pelvic infection 2 cases of repeat ambulatory MI and 1 patient requiring standard vacuum curettage with cervica dilation. 1 patient had intermittent heavy bleeding for 2 weeks after MI. It seems desirable to have a uniform term for this procedure in the professional and public vocabulary to permit accurate historical recording of these earliest pregnancy terminations and comparison of data.