NDLI: Early abortion in family medicine: clinical outcomes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Bennett, Ian M. Baylson, Margaret Kalkstein, Karin Gillespie, Ginger Bellamy, Scarlett L. Fleischman, Joan
Description	Country affiliation: United States Author Affiliation: Bennett IM ( Department of Family Medicine and Community Health, University of Pennsylvania School of Medicine, 2nd Floor Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104-4283, USA. ian.bennett@uphs.upenn.edu)
Abstract	PURPOSE: Clinical innovations have made it more feasible to incorporate early abortion into family medicine, yet the outcomes of early abortion procedures in this setting have not been well studied. We wished to assess the outcomes of first-trimester medication and aspiration abortion procedures by family physicians. METHODS: Prospective observational cohort study conducted from August 2001 to February 2005 of 2,550 women who sought pregnancy termination in 4 clinical practices of family medicine departments and 1 private office/training site. RESULTS: The rate of successful uncomplicated procedures for medication was 96.5% (95.5%-97.1% [corrected] confidence interval [CI], 95.5%-97.0%) and for aspiration was 99.9% (CI, 99.3%-1). Adverse events and complications of medication abortions were failed procedure (ongoing pregnancy; n = 19, 1.45%); incomplete abortion (n = 16, 1.22%); hemorrhage (n = 9, 0.69%); and patient request for aspiration (n = 1, 0.08%). One (0.08%) missed ectopic pregnancy was seen among patients receiving medication. Four types of adverse outcomes were encountered with aspiration: incomplete abortion requiring re-aspiration (n = 21, 1.83%); hemorrhage during the procedure (n = 4, 0.35%); missed ectopic pregnancy (n = 3, 0.26%); and minor endometritis (n = 1, 0.09%). Missed ectopic pregnancies were successfully treated in the inpatient setting without mortality (overall hospitalization rate of 0.16 of 100). All other complications were managed within outpatient family medicine sites. Rates of complication did not vary by experience of physician or by site of care (residency vs private practice). CONCLUSIONS: Complications of medication and aspiration procedures occurred at a low rate, and most were minor and managed without incident.
File Format	HTM / HTML
ISSN	15441709
e-ISSN	15441717
DOI	10.1370/afm.1051
Journal	The Annals of Family Medicine
Issue Number	6
Volume Number	7
Language	English
Publisher	Annals of Family Medicine Inc
Publisher Date	2009-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Family Medicine Abortion, Induced Abortifacient Agents Therapeutic Use Adverse Effects Adolescent Education, Medical, Continuing Internship And Residency Pregnancy Pregnancy Trimester, First Pregnancy, Ectopic Diagnosis Private Practice Vacuum Curettage
Content Type	Text
Resource Type	Article
Subject	Family Practice

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