Reviewer ’s report  
 
Title: Complications related to induced abortion: A combined retrospective and longitudinal  
follow -up study  
 
Version: 1 Date: 15 Dec 2017  
 
Reviewer: Oskari Heikinheimo  
 
Reviewer's report:  
Carlsson et al. report abortion related complications over a period of 8 years using a large 
material (nearly 5000 cases) in a large Swedish hospital. The material is valuable, and merits t o 
be reported. However, the current ms has several shortcomings which need to be taken care of 
before the paper is considered further. Some of these are:  
 
- the current style of presentation is very wordy and not representative of a scientific paper. Thus 
the paper must be condensed significantly. For example, as a rule thumb the Introduction should 
fit on one A4 page. Also, the current version of the Introduction contains several paragraphs, 
which should be selfevident for all readers of BMC Women's Health . The need to condense and 
critically review the text applies throughout the ms.  
- the paper aims to put everything in one bag - medical abortion, surgical abortion and late 
medical abortion. Would it be possible to concentrate on the first trimester abort ion only?  
- the paper contains layman's terminology and spelling errors, such as 'abortion pill mifegyne' 
and 'misoprolol' instead of misoprostol.  
- how were the complications defined? What were the criteria for post -abortal infection, and 
especially for i ncomplete abortion. Was the increase in incomplete abortion related to increased 
use of ultrasonography? Even in experienced hand increased use of US results in increased rate 
of 'incomplete abortion' and most likely unnecessary interventions.  
 
The first author is a junior doctor. Has she received sufficient guidance and support when 
preparing the ms? One alternative is that the authors identify a Swedish expert on abortion care 
(there are several excellent names) to help them when rewriting the paper.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
No 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Yes 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript : 
Not suitable for publication unless extensively edited  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in  any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to t he content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing intere sts' 
below. If your reply is yes to any, please give details below.  
I have served on advisory boards for Bayer Healthcare, Exelgyn, Gedeon Richter and MSD 
Finland (part of Merck & Co. Inc.) and designed and lectured at educational events connected 
with these companies.  
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