OBJECTIVES: To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester. DESIGN: Patient centred, partially 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 of abortion 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 useful tool in pragmatic research.
RCT Entities:
OBJECTIVES: To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester. DESIGN:Patient centred, partially 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 of abortion 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 useful tool in pragmatic research.
Entities:
Keywords:
Aberdeen Maternity Hospital (Scotland); Empirical Approach; Genetics and Reproduction; Abortion, Drug Induced; Abortion, Induced; Biology; Clinical Research; Comparative Studies; Contraception; Contraceptive Usage; Developed Countries; Endocrine System; Europe; Family Planning; Fertility Control, Postconception; Fetus; Gestational Age; Health Services Evaluation; Hormone Antagonists; Hormones; Method Acceptability; Northern Europe; Organization And Administration; Physiology; Pregnancy; Program Evaluation; Programs; Prostaglandins; Prostaglandins, Synthetic; Quality Of Health Care; Reproduction; Research Methodology; Research Report; Ru-486; Scotland; Studies; United Kingdom; Vacuum Aspiration