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Br J Obstet Gynaecol. 1997 Jul;104(7):829-33.

Medical abortion or vacuum aspiration? Two year follow up of a patient preference trial.

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Department of Public Health, University of Aberdeen, Foresterhill, UK.



To describe and compare health outcomes two years after medical abortion or vacuum aspiration in women recruited into a patient preference trial during 1990 to 1991.


Women recruited to the original, partially randomised study were contacted for assessment using a structured interview.


Grampian region of Scotland, UK.


One hundred and forty women who had participated in a partially randomised study of first trimester abortion two years previously.


Vacuum aspiration or medical abortion using mifepristone and gemeprost.


Long-term general, reproductive and psychological health; acceptability of procedure; perceived value of choice of method of termination.


There were no significant differences between women who had undergone medical abortion or vacuum aspiration two years previously in general, reproductive or psychological health. Almost all women placed a high value on the provision of choice of method of termination. There was a significant difference in perception of long term procedure acceptability among women who had been randomised to a method of termination.


Women should have the opportunity to choose the method of termination. This opportunity will result in high levels of acceptability, particularly at gestations under 50 days of amenorrhoea.


In a comparative study conducted during 1990-91, 363 Scottish women with pregnancies of less than 64 days of gestation were given the option of selecting medical abortion with mifepristone/gemeprost or surgical vacuum aspiration abortion; those without a preference were randomly assigned to a method. There were no differences between groups in efficacy or medical complications at the 21-day postabortion follow-up. Medical abortion was associated with significantly more pain during the procedure, but not following hospital discharge, and its efficacy decreased with advancing gestation. At a median time interval of 26 months after the abortion, 140 women from the original cohort were reinterviewed to assess long-term acceptability. There were no significant differences between the medical and surgical abortion groups at long-term follow-up in their assessment of their current health status, the nature and incidence of subsequent morbidity requiring a doctor's care, consultations for psychiatric problems, or menstrual disorders. 9% of women who opted for surgical abortion and 11% who chose medical abortion indicated they would select a different method in the future. Vacuum aspiration remained significantly more acceptable than medical abortion among women who were randomly allocated to an abortion group. 97 women (69%) rated the opportunity to choose an abortion method as highly important, and 86-90% indicated a willingness to pay for the provision of such choice.

[Indexed for MEDLINE]

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