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.
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
Marlene B
MB
Goldman
Jane S
JS
Occhiuto
Laura E
LE
Peterson
Jane G
JG
Zapka
R Heather
RH
Palmer
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