{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T16:33:29Z","timestamp":1772037209760,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,4,26]],"date-time":"2018-04-26T00:00:00Z","timestamp":1524700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Intrauterine adhesions (<jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s) are a problematic complication after termination of pregnancy, but their incidence is unknown. Our objective was to assess the incidence of <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s following induced termination of pregnancy and the risk factors for <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A nationwide registry study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>All women undergoing induced termination of pregnancy (<jats:italic>n<\/jats:italic> = 80 015) in Finland between 2000 and 2008.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The data were retrieved from the Finnish Abortion Registry and the Hospital Discharge Registry. The diagnosis of <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s or complications was based on the diagnostic codes (International Statistical Classification of Diseases and Related Health Problems 10th Revision, <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u201010) and operative codes according to the Nordic Medico\u2010Statistical Committee (<jats:styled-content style=\"fixed-case\">NOMESCO<\/jats:styled-content>) Classification of Surgical Procedures (<jats:styled-content style=\"fixed-case\">NCSP<\/jats:styled-content>). <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s were defined as <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u201010 code N85.6 or operative code <jats:styled-content style=\"fixed-case\">LCG<\/jats:styled-content>02. A subanalysis of <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content> cases and five matched controls was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The incidence of and risk factors for <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 12 (1.5 per 10 000) <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content> diagnoses were identified from 79 960 eligible induced terminations of pregnancy. The rate of <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s was 1.5 and 2.0 cases per 10 000 terminations of pregnancy following medically and surgically induced termination of pregnancy, respectively (<jats:italic>P<\/jats:italic> = 0.19). In a subgroup analysis of <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content> cases and five matched controls, surgical treatment of the remaining products of conception following termination of pregnancy significantly increased the risk of <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s (odds ratio, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 5.50; 95% confidence interval, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.46\u201320.79; <jats:italic>P<\/jats:italic> = 0.012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s that require further treatment are rare after an induced termination of pregnancy. Surgical evacuation following medical or surgical termination of pregnancy was a risk factor for the diagnosis of <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s. These results suggest that trauma to a recently pregnant uterus is an important risk factor for <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content> is rare after induced termination of pregnancy (<jats:styled-content style=\"fixed-case\">iTOP<\/jats:styled-content>), but surgical evacuation is a risk factor for <jats:styled-content style=\"fixed-case\">IUA<\/jats:styled-content>s.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15216","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T10:30:41Z","timestamp":1521109841000},"page":"1424-1431","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Intrauterine adhesions following an induced termination of pregnancy: a nationwide cohort study"],"prefix":"10.1111","volume":"125","author":[{"given":"M","family":"Mentula","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"M\u00e4nnist\u00f6","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology PEDEGO Research Unit Medical Research Center Oulu University Hospital of Oulu and University of Oulu Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Gissler","sequence":"additional","affiliation":[{"name":"The National Institute for Health and Welfare Helsinki Finland"},{"name":"Department of Neurobiology, Care Sciences and Society Division of Family Medicine Karolinska Institute Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O","family":"Heikinheimo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Niinim\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology PEDEGO Research Unit Medical Research Center Oulu University Hospital of Oulu and University of Oulu Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,4,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2010.11.018"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.02.096"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.10.026"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2001.801103.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.10.036"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.08.039"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2016.1199795"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.11.016"},{"issue":"11","key":"e_1_2_6_10_1","first-page":"CD011110","article-title":"Anti\u2010adhesion therapy following operative hysteroscopy for treatment of female subfertility","author":"Bosteels J","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30413-8"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12347"},{"issue":"11","key":"e_1_2_6_13_1","first-page":"CD002855","article-title":"Medical methods for first trimester abortion","author":"Kulier R","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"e_1_2_6_14_1","first-page":"CD005216","article-title":"Medical methods for mid\u2010trimester termination of pregnancy","author":"Wildschut H","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"e_1_2_6_15_1","first-page":"CD006714","article-title":"Surgical versus medical methods for second trimester induced abortion","author":"Lohr PA","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"e_1_2_6_16_1","first-page":"CD003037","article-title":"Medical versus surgical methods for first trimester termination of pregnancy","author":"Say L","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6512a1"},{"key":"e_1_2_6_18_1","unstructured":"Abortion Statistics England and Wales:2014. 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