Physician assistants as providers of surgically induced abortion services.
OBJECTIVE
We compared complication rates after surgical abortions performed by physician assistants with rates after abortions performed by physicians.


METHODS
A 2-year prospective cohort study of women undergoing surgically induced abortion was conducted. Ninety-one percent of eligible women (1363) were enrolled.


RESULTS
Total complication rates were 22.0 per 1000 procedures (95% confidence interval [CI] = 11.9, 39.2) performed by physician assistants and 23.3 per 1000 procedures (95% CI = 14.5, 36.8) performed by physicians (P =.88). The most common complication that occurred during physician assistant-performed procedures was incomplete abortion; during physician-performed procedures the most common complication was infection not requiring hospitalization. A history of pelvic inflammatory disease was associated with an increased risk of total complications (odds ratio = 2.1; 95% CI = 1.1, 4.1).


CONCLUSIONS
Surgical abortion services provided by experienced physician assistants were comparable in safety and efficacy to those provided by physicians.
Goldman
Marlene B
MB
Department of Obstetrics and Gynecology, and Reproductive Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA. mgoldman@bidmc.harvard.edu
Occhiuto
Jane S
JS
Peterson
Laura E
LE
Zapka
Jane G
JG
Palmer
R Heather
RH
D000027:Abortion, Incomplete / Q000453:epidemiology / Q000209:etiology; D000029:Abortion, Legal / Q000009:adverse effects / Q000295:instrumentation / Q000523:psychology / Q000706:statistics & numerical data; D000328:Adult; D001294:Attitude to Health; D005260:Female; D005865:Gestational Age; D006801:Humans; D008875:Middle Aged; D009513:New Hampshire / Q000453:epidemiology; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000453:epidemiology; D010823:Physician Assistants / Q000193:education / Q000592:standards*; D010820:Physicians / Q000592:standards; D024382:Professional Role; D011446:Prospective Studies; D011645:Puerperal Infection / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012449:Safety; D011795:Surveys and Questionnaires; D014619:Vacuum Curettage / Q000009:adverse effects / Q000295:instrumentation / Q000523:psychology / Q000706:statistics & numerical data; D014707:Vermont / Q000453:epidemiology