Impact of the introduction of new medical methods on therapeutic abortions at the Royal Infirmary of Edinburgh

S T Cameron, A F Glasier, J Logan, L Benton, D T Baird
British Journal of Obstetrics and Gynaecology 1996, 103 (12): 1222-9

OBJECTIVE: To assess the impact of the introduction of new medical methods on the provision of therapeutic abortions at the Royal Infirmary Edinburgh.

DESIGN: A review of the total number of abortions performed by medical and surgical means between 1989 and 1995 (inclusive); a prospective survey of the terminations of pregnancy (< or = 9 weeks of gestation) performed over the six-month period of January to June 1994; and a questionnaire of the reasons why women chosen a particular method.

SETTING: Large teaching hospital in Scotland.

SUBJECTS: One thousand and seven women seeking early pregnancy termination between January and June 1994.

MAIN OUTCOME MEASURES: Proportion of pregnancies terminated by medical means; comparison of complete abortion rate, incidence of complications and morbidity following both medical and surgical methods (< or = 9 weeks of gestation); reasons for preference of the method of abortion.

RESULTS: Since 1991 there has been a progressive increase in the number of medical abortions performed at the Royal Infirmary of Edinburgh, and by 1994 the majority of women (57%) seeking abortion at < or = 9 weeks chose a medical method. Women who chose medical abortion had more years at full-time education and were less likely to smoke (P < 0.04). Both medical and surgical methods were highly effective (> 96% complete abortion) with a low incidence of complications and morbidity. However, women who had chosen the medical method were less likely to receive antibiotics for suspected endometritis than their surgical counterparts (chi 2, P = 0.0001).

CONCLUSIONS: If this trend towards medical methods in Edinburgh is repeated elsewhere, it will inevitably have an impact on gynaecological services by releasing staff and operating time for other purposes.

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