Background The commonest reason for undertaking termination of pregnancy (TOP) in the UK is as defined by Clause 2 of the Abortion Act. There are no agreed criteria for defining 'recurrent abortion seekers'. We aimed to review the characteristics of women requesting termination of at least two consecutive pregnancies within 24 months of the first and to identify any factors for seeking repeat TOP. MethodsThe database of patients that attended our Fertility Control Services from 2001 to 2006 was evaluated. Demographic data, contraceptive use in the cycle of conception and reasons for request were assessed for possible associations with repeat TOP. ResultsThe incidence was 2.3% as defined by our criteria. Financial circumstances was the commonest reason for seeking TOP (75%). The combined oral contraceptive pill and condom were the commonest forms 93 IntroductionIn England and Wales, abortion rates rose from 186 400 in 2005 to 193 700 in 2006. Despite the availability and easy accessibility of contraceptive services, one in four abortions in the UK was a repeat episode. 1 The most common indication for abortion in the UK is Clause C of the Abortion Act 1967 (i.e. a pregnancy that threatens the mental or physical health of a woman). Generally, unwanted pregnancies result from lack of awareness of emergency contraception (EC) and poor compliance or improper use of contraception, with the user-dependent modalities worsening the situation. Most women undergoing an abortion will have had unprotected intercourse or will have been using a contraceptive method that has high failure rates associated with typical use, mainly condoms or combined contraceptive pills (COCs). 2 Contraceptive methods that are independent of daily compliance for their effectiveness, such as long-acting reversible contraception (LARC), are associated with very low failure rates even with typical use but are used by less than 8% of women in the UK. 3,4 Moreover, for all methods of contraception, discontinuation rates are disappointingly high. 5 We aimed to establish the rate of repeat abortion seekers within the population catered for by our pregnancy termination service and to compare the rate with similar services worldwide. We also aimed to use any specific characteristics identified to develop strategies to reduce repeat abortion. A review of the scientific literature indicated that there is a lack of consensus regarding the definition of 'repeat abortion'. Authors have used their own criteria to define repeat aborters, for example, Nguyen et Correspondence to: Dr Sangeeta Das, Department of Obstetrics and Gynaecology, Royal Bolton Hospital, Minerva Road, Bolton BL4 0JR, UK. E-mail: sangeetadas65@aol.com of contraception in these patients before the first TOP (35% and 38%, respectively). Long-acting reversible contraception (LARC) was used by only 8% of women before their TOP. Although 58% accepted LARC following TOP, only 2% continued its use thereafter and 50% of women were not using any contraception at the time of the repeat TOP. ...

Background: Uterus didelphys is a Müllerian duct anomaly which is clinically significant because only 45% of UD patients achieve term delivery and have associated increased risk of spontaneous abortion, foetal growth retardation, mal presentation, and a significant caesarean section delivery rate. Case: A 26-year-old Gravida 2 Para 1 Abortion 1 woman with uterus didelphys and associated complete, non-communicating, longitudinal vaginal septum carries a pregnancy to term in her right uterus in rural Canada. She delivers her baby at 41 weeks gestational age via vacuum assisted spontaneous vaginal delivery. Conclusion: This case report supports more recent literature that uterus didelphys should not be considered as an absolute indication for caesarean delivery. A trial of labour is conceivable with obstetrician gynaecologist involvement in more rural centers with a care plan in place.