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REVIEW

Three years on: a review of medical terminations of pregnancy performed in a sexual health service

Sandra Downing A B , Heather McNamee A , Debbie Penney A , Joanne Leamy A , Caroline de Costa A and Darren B. Russell A
+ Author Affiliations
- Author Affiliations

A Cairns Sexual Health Service, PO Box 902, Cairns, Qld 4870, Australia.

B Corresponding author. Email: sandra_downing@health.qld.gov.au

Sexual Health 7(2) 212-215 https://doi.org/10.1071/SH09139
Submitted: 9 December 2009  Accepted: 23 February 2010   Published: 14 May 2010

Abstract

Access to abortion services is often limited in parts of regional Australia, including north Queensland. Since March 2006, the Cairns Sexual Health Service (CSHS) has provided medical termination of pregnancy (MToP) services for women up to 9 weeks gestation, using a regimen of methotrexate and misoprostol. We conducted a retrospective chart audit of all women undergoing an MToP at the CSHS between 1 March 2006 and 31 March 2009. In total, 147 medical terminations in 136 women were performed during this 3-year period. At the time of first presentation, the mean age was 27 years, 77 (57%) of the 136 women were of less than 7 weeks gestation and 86 (63%) had not had a previous termination. A successful medical termination of pregnancy was achieved in 69 of 85 (81%, 95% confidence interval (CI): 72, 88) women at less than 7 weeks gestation and in 43 of 62 (69%, 95% CI: 57, 80) women with gestation between 7 and 9 weeks. Provision of medical termination of pregnancy through sexual health services is one strategy to address access inequity in regional areas. Demand for this service in Cairns continues to rise; however, since late August 2009 MToP in Queensland is no longer available pending legal reform.

Additional keywords: medical abortion, methotrexate, misoprostol.


References


[1] Creinin MD,  Potter C,  Holovanisin M,  Janczukiewicz L,  Pymar HC,  Schwartz JL, et al. Mifepristone and misoprostol and methotrexate/misoprostol in clinical practice for abortion. Am J Obstet Gynecol 2003; 188 664–9.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[2] Pymar HC,  Creinin MD. Alternatives to mifepristone regimens for medical abortion. Am J Obstet Gynecol 2000; 183 54–64.
Crossref | GoogleScholarGoogle Scholar |

[3] Creinin MD. Randomized comparison of efficacy, acceptability and cost of medical versus surgical abortion. Contraception 2000; 62 117–24.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[4] Creinin MD,  Vittinghoff E,  Keder L,  Darney PD,  Tiller G. Methotrexate and misoprostol for early abortion: a multicenter trial. I. Safety and efficacy. Contraception 1996; 53 321–7.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[5] Özeren M,  Bilekli C,  Aydemir V,  Bozkaya H. Methotrexate and misoprostol used alone or in combination for early abortion. Contraception 1999; 59 389–94.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[6] Borgatta L,  French A,  Vragovic O,  Burnhill MS. Early medical abortion with methotrexate and misoprostol: outcomes and satisfaction among women aged 15–21 years. J Pediatr Adolesc Gynecol 2001; 14 9–16.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[7] Australian Bureau of Statistics. Census of population and housing: 2006 Census Basic Community Profile. Canberra: Australia Bureau of Statistics; 2007.

[8] Maclean J . Chlamydia testing in pregnancy: an audit of deliveries at Cairns Base Hospital in 2008. [Masters research project – unpublished]. Perth: Curtin University of Technology; 2009.

[9] Creinin MD,  Vittinghoff E,  Schaff E,  Klaisle C,  Darney PD,  Dean C. Medical abortion with oral methotrexate and vaginal misoprostol. Obstet Gynecol 1997; 90 611–6.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[10] Wiebe ER. Oral methotrexate compared with injected methotrexate when used with misoprostol for abortion. Am J Obstet Gynecol 1999; 181 149–52.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |