Results of a 4-year study on 15,447 medical abortions provided by privately practicing general practitioners and gynecologists in France.
BACKGROUND
The main aim of this study was to determine: (1) whether early medical abortion at home is a reliable and safe method when provided by physicians in their private practice outside abortion facilities, and (2) whether early medical abortions at home supervised by general practitioners (GPs) in their private practice have the same efficacy rate and the same safety as those supervised by gynecologists in their private practice.


METHODS
The data are drawn from a prospective survey of 15,447 in-home medical abortions up to 49 days after the last menstrual period (LMP), provided within the Ile-de-France abortion network between privately practicing physicians and hospitals (REVHO: Réseau entre la ville et l'hôpital pour l'orthogénie), from 2005 to 2008.


RESULTS
Approximately 150 privately practicing physicians participate in the REVHO network, and over half of them are general practitioners. Three physicians, called the main providers, performed over half the medical abortions. The overall efficacy rate was 97.43% (96.48 % for the gynecologists, 96.44% for the general practitioners, and 98.31 % for the three main providers). The rate was higher when abortion completion was determined by a decline in serum human chorionic gonadotropin rather than ultrasound.


CONCLUSIONS
Early medical abortion at home supervised by gynecologists and GPs practicing in their private offices is a reliable and safe method. Promoting networks such as REVHO increases local accessibility to this type of abortion in France.
REVHO, Hôpital Tarnier, 89 rue d'Assas, 75006 Paris, France. s.gaudu@revho.fr
Sophie
S
Gaudu
Monique
M
Crost
Laurence
L
Esterle
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000009:adverse effects / Q000706:statistics & numerical data* / Q000639:trends; D000293:Adolescent; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D058006:General Practice / Q000706:statistics & numerical data* / Q000639:trends; D006176:Gynecology / Q000706:statistics & numerical data* / Q000639:trends; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage; D016595:Misoprostol / Q000008:administration & dosage; D010818:Practice Patterns, Physicians' / Q000639:trends; D011331:Private Practice / Q000706:statistics & numerical data; D011446:Prospective Studies; D012646:Self Administration / Q000706:statistics & numerical data*; D014463:Ultrasonography / Q000706:statistics & numerical data; D055815:Young Adult
D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D006063:Chorionic Gonadotropin; D016595:Misoprostol; D015735:Mifepristone