Surgical and medical second trimester abortion in South Africa: A cross-sectional study

 

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dc.contributor.author Grossman, Daniel en_ZA
dc.contributor.author Constant, Deborah en_ZA
dc.contributor.author Lince, Naomi en_ZA
dc.contributor.author Alblas, Marijke en_ZA
dc.contributor.author Blanchard, Kelly en_ZA
dc.contributor.author Harries, Jane en_ZA
dc.date.accessioned 2015-10-28T06:55:39Z
dc.date.available 2015-10-28T06:55:39Z
dc.date.issued 2011 en_ZA
dc.identifier.citation Grossman, D., Constant, D., Lince, N., Alblas, M., Blanchard, K., & Harries, J. (2011). Surgical and medical second trimester abortion in South Africa: A cross-sectional study. BMC health services research, 11(1), 224. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14443
dc.identifier.uri http://dx.doi.org/10.1186/1472-6963-11-224
dc.description.abstract BACKGROUND:A high percentage of abortions performed in South Africa are in the second trimester. However, little research focuses on women's experiences seeking second trimester abortion or the efficacy and safety of these services.The objectives are to document clinical and acceptability outcomes of second trimester medical and surgical abortion as performed at public hospitals in the Western Cape Province. METHODS: We performed a cross-sectional study of women undergoing abortion at 12.1-20.9 weeks at five hospitals in Western Cape Province, South Africa in 2008. Two hundred and twenty women underwent D&E with misoprostol cervical priming, and 84 underwent induction with misoprostol alone. Information was obtained about the procedure and immediate complications, and women were interviewed after recovery. RESULTS: Median gestational age at abortion was earlier for D&E clients compared to induction (16.0 weeks vs. 18.1 weeks, p < 0.001). D&E clients reported shorter intervals between first clinic visit and abortion (median 17 vs. 30 days, p < 0.001). D&E was more effective than induction (99.5% vs. 50.0% of cases completed on-site without unplanned surgical procedure, p < 0.001). Although immediate complications were similar (43.8% D&E vs. 52.4% induction), all three major complications occurred with induction. Early fetal expulsion occurred in 43.3% of D&E cases. While D&E clients reported higher pain levels and emotional discomfort, most women were satisfied with their experience. CONCLUSIONS: As currently performed in South Africa, second trimester abortions by D&E were more effective than induction procedures, required shorter hospital stay, had fewer major immediate complications and were associated with shorter delays accessing care. Both services can be improved by implementing evidence-based protocols. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/2.0 en_ZA
dc.source BMC Health Services Research en_ZA
dc.source.uri http://www.biomedcentral.com/bmchealthservres/ en_ZA
dc.subject.other Abortion en_ZA
dc.title Surgical and medical second trimester abortion in South Africa: A cross-sectional study en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2011 Grossman et al; licensee BioMed Central Ltd. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Women's Health Research Unit en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Grossman, D., Constant, D., Lince, N., Alblas, M., Blanchard, K., & Harries, J. (2011). Surgical and medical second trimester abortion in South Africa: A cross-sectional study. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/14443 en_ZA
dc.identifier.chicagocitation Grossman, Daniel, Deborah Constant, Naomi Lince, Marijke Alblas, Kelly Blanchard, and Jane Harries "Surgical and medical second trimester abortion in South Africa: A cross-sectional study." <i>BMC Health Services Research</i> (2011) http://hdl.handle.net/11427/14443 en_ZA
dc.identifier.vancouvercitation Grossman D, Constant D, Lince N, Alblas M, Blanchard K, Harries J. Surgical and medical second trimester abortion in South Africa: A cross-sectional study. BMC Health Services Research. 2011; http://hdl.handle.net/11427/14443. en_ZA
dc.identifier.ris TY - Journal Article AU - Grossman, Daniel AU - Constant, Deborah AU - Lince, Naomi AU - Alblas, Marijke AU - Blanchard, Kelly AU - Harries, Jane AB - BACKGROUND:A high percentage of abortions performed in South Africa are in the second trimester. However, little research focuses on women's experiences seeking second trimester abortion or the efficacy and safety of these services.The objectives are to document clinical and acceptability outcomes of second trimester medical and surgical abortion as performed at public hospitals in the Western Cape Province. METHODS: We performed a cross-sectional study of women undergoing abortion at 12.1-20.9 weeks at five hospitals in Western Cape Province, South Africa in 2008. Two hundred and twenty women underwent D&E with misoprostol cervical priming, and 84 underwent induction with misoprostol alone. Information was obtained about the procedure and immediate complications, and women were interviewed after recovery. RESULTS: Median gestational age at abortion was earlier for D&E clients compared to induction (16.0 weeks vs. 18.1 weeks, p < 0.001). D&E clients reported shorter intervals between first clinic visit and abortion (median 17 vs. 30 days, p < 0.001). D&E was more effective than induction (99.5% vs. 50.0% of cases completed on-site without unplanned surgical procedure, p < 0.001). Although immediate complications were similar (43.8% D&E vs. 52.4% induction), all three major complications occurred with induction. Early fetal expulsion occurred in 43.3% of D&E cases. While D&E clients reported higher pain levels and emotional discomfort, most women were satisfied with their experience. CONCLUSIONS: As currently performed in South Africa, second trimester abortions by D&E were more effective than induction procedures, required shorter hospital stay, had fewer major immediate complications and were associated with shorter delays accessing care. Both services can be improved by implementing evidence-based protocols. DA - 2011 DB - OpenUCT DO - 10.1186/1472-6963-11-224 DP - University of Cape Town J1 - BMC Health Services Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Surgical and medical second trimester abortion in South Africa: A cross-sectional study TI - Surgical and medical second trimester abortion in South Africa: A cross-sectional study UR - http://hdl.handle.net/11427/14443 ER - en_ZA


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