“In patient” medical abortion versus surgical abortion: patient’s satisfaction

Abstract

Objective: To compare patients’ satisfaction with medical and surgical abortion, implementing the Italian guidelines on medical abortion entailing an “in patient” procedure.

Methods: A total of 1832 pregnant chose between surgical (vacuum aspiration) or medical abortion (mifepristone p.o. followed after 3 days by sublingual misoprostol) and expressed their expected satisfaction on a visual analog scale (VAS). A total of 885 women chose surgical and 947 medical abortion. The primary end-point was satisfaction VAS score 20 days after the procedure. Secondary end-points were: difference between pre- and post-abortion VAS score; difference in satisfaction VAS scores according to parity and previous abortion; incidence of side effects.

Results: VAS score was high in each group but significantly higher for the 1-day surgical than for the 3-day medical abortion procedure (7.9 ± 1.0 versus 7.2 ± 1.2; p < 0.0001). In the surgical group the VAS score increased after the treatment (6.9 ± 1.6 versus 7.9 ± 1.0, p < 0.0001), while it decreased in the medical group (7.5 ± 1.0 versus 7.2 ± 1.2; p < 0.0001). Multiparous women reported higher satisfaction with medical abortion; women with a previous abortion preferred surgical abortion.

Conclusions: Both procedures are considered satisfactory by the patients. Performing medical abortion as a 3-day “in patient” procedure, decreased women’s satisfaction scores from their baseline expectations.

Chinese abstract

目的: 为了比较患者对药物流产和手术流产的满意度, 实施药物流产的意大利指南, 使住院过程更加满意。

方法: 共有1832名孕妇选择手术（负压吸引术）或者药物流产（舌下含化米索前列腺醇3天后口服米非司酮）, 并且在视觉模拟量表（VAS）上表达她们的预期满意度。有885名妇女选择手术流产, 947名妇女选择药物流产。主要终点是流产后20天的VAS满意度评分。次要终点是: 流产前后VAS评分的差异；取决于产次和以前流产次数的VAS满意度评分的差异；副作用的发生率。

结果: 每一组的VAS评分都是高的, 但是为期一天的手术流产方法显著高于为期三天的药物流产方法（7.9 ± 1.0 vs 7.2 ± 1.2; P < 0.0001）.在手术组, 治疗后的VAS评分升高了（6.9 ± 1.6 vs 7.9 ± 1.0; P < 0.0001）, 然而药物组治疗后的VAS评分却降低了（7.5 ± 1.0 vs 7.2 ± 1.2; P < 0.0001）。据报道, 多次生产的妇女对药物流产的满意度较高；以前有过流产的妇女首选手术流产。

结论: 两种手术方法都是由患者考虑满意度。采用为期3天的住院药物流产过程, 从预期基线水平降低了妇女的满意度评分。

• Mifepristone
• misoprostol
• medical abortion
• surgical abortion

Acknowledgements

The authors wish to thank Mrs. Pasqualina Sirica, Midwife in charge of the pregnancy termination unit of our Department, for her precious cooperation.

Declaration of interest

The authors report no conflicts of interest.