title: Follow-up after early medical abortion: Comparing clinical assessment with self-assessment in a rural hospital in northern Norway.
abstract: OBJECTIVE
  A follow-up study was performed on women who had requested medical abortions in a rural hospital in northern Norway to compare clinical assessment with self-assessment of early medical abortion in terms of safety.
  
  
  METHODS
  During the three-year study period, 392 women requested termination of pregnancy. After excluding those who changed their mind, those who had a spontaneous miscarriage, those who were referred to a central hospital for a two-stage abortion, and those who had the abortion performed surgically, 242 cases remained, and all the medical files were reviewed. Five cases (2%) were lost to follow-up, so the study group consists of 237 cases.
  
  
  RESULTS
  Out of the 237 cases, in which a medical abortion was performed, 106 were performed at home with a self-assessment (44.7%), and 131 (55.3%) were performed at the department of Gynecology. The percentage of cases with self-assessment did not noticeably change during the three-year study period. The registered complications were infection, incomplete abortion requiring a surgical procedure and hospitalization due to severe pain. No significant difference in registered complications was found between medical abortions with self-assessment (n=9, 8.5% out of 106 cases) and medical abortions at the gynecological out-patient department (n=6, 4.6% out of 131 cases).
  
  
  CONCLUSIONS
  According to this investigation, it is equally safe to perform a medical abortion at home with a self-assessment as it is to have a medical abortion at an outpatient clinic. These results could be useful for health care provision in rural areas where access to hospitals is impeded by logistical difficulties.
authors.affiliation: Helgelandssykehuset Mo i Rana, N-8607 Mo i Rana, Norway.
authors.forename: Carl-Gustav
authors.initials: CG
authors.lastname: Mählck
authors.affiliation: University of Umeå, Department of Clinical Sciences, Obstetrics and Gynecology, S-901 85 Umeå, Sweden. Electronic address: Torbjorn.c.Backstrom@umu.se.
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Bäckström
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006699:Home Care Services; D006780:Hospitals, Rural; D006801:Humans; D009664:Norway; D017060:Patient Satisfaction; D011247:Pregnancy; D012189:Retrospective Studies; D057566:Self Report; D016896:Treatment Outcome
keywords: Complications; Medical abortions; Rural hospital