Comparison of medical abortion with surgical vacuum aspiration: women's preferences and acceptability of treatment.

Abstract

Objectives-To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester.Design-Patient centred, pardally randomised trial. Medical abortion was performed with mifepristone 600 mg followed 48 hours later by gemeprost 1 mg vaginal pessary. Vacuum aspiration was performed under general anaesthesia.Setting-Teaching hospital in Scotland.Patients-363 women undergoing legal induced abortion at less than nine weeks' gestation.Main outcome measures-Women's preferences for method ofabortion before abortion; acceptability judged two weeks after abortion by recording the method women would opt to undergo in future and by semantic differential rating technique.Results-73 (20%) women preferred to undergo medical abortion, and 95 (26%) vacuum aspiration; 195 (54%) were willing to undergo either method, and were allocated at random. Both procedures were highly acceptable to women with preferences. Gestation had a definite effect on acceptability in randomised women; at less than 50 days there were no differences, but between 50 and 63 days vacuum aspiration was significantly more acceptable.Conclusions-Women who wish to use a particular method should be allowed their choice, regardless of gestation. Women of 50-63 days' gestation without preferences for a particular method are likely to find vacuum aspiration more acceptable. A patient centred, partially randomised trial design may be a usefil tool in pragmatic research.

Socio-epidemiological factors of medical termination of pregnancy:an overview in a tertiary care institute

“…Though there is changing trends for medical method of termination of pregnancy but the surgical method is still favoured. 7 The surgical method was used in 221 candidates in comparison to medical method used in 59 cases. The professional decision made favour surgical method over the medical method in the institute.…”

Clinical and economic evaluation of laparoscopic surgery compared with medical management for gastro-oesophageal reflux disease: 5-year follow-up of multicentre randomised trial (the REFLUX trial)

“…26 Furthermore, preference may influence outcome and, if so, this may also help when making treatment decisions. 26,27 A third reason for the parallel, non-randomised preference groups 28 was that the addition of data from the preference groups may reduce imprecision around the estimates from the randomised comparison and this may be particularly useful for rare events, such as complications that can be confidently ascribed to one or other treatment. (The limitation is that the preference groups are not derived by random allocation, and hence the comparisons are exposed to the biases of non-randomised studies.…”

Immediate impact of medical abortion on women's health and clients' satisfaction with medical abortion

“…The non-invasive aspect of MA, as opposed to a vacuum aspiration procedure, is often mentioned as a signifi cant benefi t. Some women perceive MA as a more private and natural method. Women may take the medications at home, which gives them more control over the conditions under which they have the abortion 14,15 .…”