{{Short description|Surgical procedure}} {{Infobox abortion method |[[File:Illustration of a Hysterotomy.jpg|thumb|Illustration of a hysterotomy from page 564 of "A System of midwifery: including the diseases of pregnancy and the puerperal state"]] | name = Hysterotomy abortion | AKA/Abbreviation= | Abortion_type = Surgical | Date_first_use = <1913 | Date_last_use = | Usage_notes = U.S. figures include both hysterotomy and [[hysterectomy]]. | Use_AU% = <!-- Australia --> | Use_AU_date = | Use_CA% = <!-- Canada--> | Use_CA_date = | Use_NZ% = | Use_NZ_date = | Use_SE% = | Use_SE_date = | Use_UK% = | Use_UK_date = | Use_US% = <0.01 | Use_US_date = 2016 | Use_ZA% = <!-- South Africa --> | Use_ZA_date = | Medical_notes = |Gestational_age=2nd trimester and later}}
'''Hysterotomy abortion''' is a [[Surgery|surgical procedure]] that removes an intact [[fetus]] from the [[uterus]] in a process similar to a [[cesarean section]]. The procedure is generally indicated after another method of termination has failed, or when such a procedure would be medically inadvisable, such as in the case of [[placenta accreta]].<ref name="roche">Roche, Natalie E. (June 16, 2006). [http://www.emedicine.com/med/topic3312.htm Surgical Management of Abortion]. Retrieved July 1, 2007.</ref>
In 2016, this method made up less than 0.01% of all [[abortion]]s in the United States, with the CDC reporting only 51 having occurred due to the invasive and complex nature of the procedure, and the availability of much simpler and safer methods.<ref>{{Cite journal|last=Jatlaoui|first=Tara C.|date=2019|title=Abortion Surveillance — United States, 2016|journal=MMWR. Surveillance Summaries|language=en-us|volume=68|issue=11|pages=1–41|doi=10.15585/mmwr.ss6811a1|pmid=31774741|issn=1546-0738|doi-access=free|pmc=6289084}}</ref> In 2022, scholars reported that in the aftermath of the overturning of ''[[Roe v. Wade]]'' by ''[[Dobbs v. Jackson Women's Health Organization]]'', [[Texas]] and other states where so called trigger laws immediately outlawed or heavily restricted reproductive healthcare, providers began performing hysterotomy abortions again. These providers have done so under the justification that such a procedure may not technically be considered an abortion under existing law.<ref>{{Cite journal |last1=Arey |first1=Whitney |last2=Lerma |first2=Klaira |last3=Beasley |first3=Anitra |last4=Harper |first4=Lorie |last5=Moayedi |first5=Ghazaleh |last6=White |first6=Kari |date=August 4, 2022 |title=A Preview of the Dangerous Future of Abortion Bans — Texas Senate Bill 8 |journal=[[The New England Journal of Medicine]] |volume=387 |issue=5 |pages=388–390|doi=10.1056/NEJMp2207423 |pmid=35731914 |s2cid=249956428 |doi-access=free }}</ref>
== Indications == As with other abortion procedures, the purpose of a hysterotomy abortion is to end a pregnancy by removing the fetus and placenta. This method is the most dangerous of any conventional abortion procedure, and has the highest complication rate.<ref name="roche" /> The procedure is specifically indicated in the management of certain medical conditions including Cesarean Scar Pregnancy,<ref>{{Cite journal |last1=Doğru |first1=Şükran |last2=Akkuş |first2=Fatih |last3=Atci |first3=Aslı ALTINORDU |last4=Eren |first4=Gülnur |last5=Acar |first5=Ali |date=19 Jan 2023 |title=Cesarean Scar Pregnancies and Reproductive Outcomes: A Single Center Experience |url=https://www.jcog.com.tr/article/en-cesarean-scar-pregnancies-and-reproductive-outcomes-a-single-center-experience-102344.html |journal=Journal of Clinical Obstetrics & Gynecology |language=English |volume= 33|issue= |pages= 36–42|doi=10.5336/jcog.2022-93710|s2cid=257643701 |doi-access=free }}</ref> [[bicornuate uterus]],<ref>{{Cite journal |last1=Lazenby |first1=Gweneth B. |last2=Huang |first2=Christopher |last3=Rahall |first3=Ann M. |last4=Fogelson |first4=Nicholas S. |date=March 2007 |title=Pregnancy termination via laparotomy in a woman with bicornuate uterus |url=https://linkinghub.elsevier.com/retrieve/pii/S001078240600415X |journal=Contraception |volume=75 |issue=3 |pages=241–243 |doi=10.1016/j.contraception.2006.10.007 |pmid=17303497 |issn=0010-7824|url-access=subscription }}</ref> [[Uterine fibroid|uterine fibroids]],<ref>{{Cite journal |last1=Gabrilovich |first1=Sofia |last2=Unsal |first2=Aylin |last3=Roche |first3=Natalie |last4=Barlog |first4=Lauren |date=August 2019 |title=Approach to Termination of Pregnancy in a Woman with Uterine Leiomyomas |url=https://www.liebertpub.com/doi/10.1089/gyn.2019.0008 |journal=Journal of Gynecologic Surgery |language=en |volume=35 |issue=4 |pages=270–271 |doi=10.1089/gyn.2019.0008 |issn=1042-4067|url-access=subscription }}</ref> and in the case of failure of another method or methods.<ref>{{Cite journal |last1=Baekelandt |first1=Jan |last2=Bosteels |first2=Jan |date=May 2015 |title=Laparoscopic Hysterotomy for a Failed Termination of Pregnancy: A First Case Report With Demonstration of a New Surgical Technique |url=https://linkinghub.elsevier.com/retrieve/pii/S1553465015001788 |journal=Journal of Minimally Invasive Gynecology |language=en |volume=22 |issue=4 |pages=544 |doi=10.1016/j.jmig.2015.02.007|pmid=25701623 |url-access=subscription }}</ref>
== Procedure == [[File:Illustration of a Hysterotomy.jpg|thumb|263x263px|Illustration of a hysterotomy]] [[Hysterotomy]] is major [[abdominal surgery]]; it is generally only performed in hospitals and other advanced practice settings. The procedure is nearly identical to a cesarean section, with two main exceptions: the conduction of [[foeticide]] guaranteeing compliance with various laws on the subject, and preventing an unintended live birth; and the size of the incision, which is generally smaller than that of a cesarean section, as the fetus is generally not full term. The size of the incision is not always smaller, however, as [[Late termination of pregnancy|late term]] hysterotomy abortions often remove a term fetus following foeticide.
== History == Scholarly sources place the use of this method since at least 1913.<ref>{{Cite journal|last=Bonney|first=Victor|title=On Abdominal Evacuation of the Pregnant Uterus Before Viability|date=October 1918|journal=The Lancet|volume=192|issue=4964|pages=518|doi=10.1016/s0140-6736(01)02878-1|issn=0140-6736|url=https://zenodo.org/record/1910883}}</ref> Health officials in the [[United States]] warned practitioners against performing hysterotomy abortion in an [[outpatient]] setting after it led to the deaths of two women in [[New York (state)|New York]] during 1971.<ref>{{cite journal |vauthors=Berger GS, Tietze C, Pakter J, Katz SH |title=Maternal mortality associated with legal abortion in New York State: July 1, 1970--June 30, 1972 |journal=Obstet Gynecol |volume=43 |issue=3 |pages=315–26 |date=March 1974 |pmid=4814448 }}</ref><ref>{{cite journal |vauthors=Stroh G, Katz SH, Hinman AR |title=Performing second-trimester abortions. Rationale for inpatient basis |journal=N Y State J Med |volume=75 |issue=12 |pages=2168–71 |date=October 1975 |pmid=1059921 }}</ref> The rate of [[death|mortality]] of abortion by hysterotomy and [[hysterectomy]] reported in the United States between 1972 and 1981 was 60 per 100,000, or 0.06%.<ref name="grimes">{{cite journal |vauthors=Grimes DA, Schulz KF |title=Morbidity and mortality from second-trimester abortions |journal=J Reprod Med |volume=30 |issue=7 |pages=505–14 |date=July 1985 |pmid=3897528 }}</ref>
==References== {{reflist}}
{{Abortion}}
[[Category:Methods of abortion]] [[Category:Caesarean sections]]