RT Journal Article SR Electronic T1 Early Abortion in Family Medicine: Clinical Outcomes JF The Annals of Family Medicine JO Ann Fam Med FD American Academy of Family Physicians SP 527 OP 533 DO 10.1370/afm.1051 VO 7 IS 6 A1 Bennett, Ian M. A1 Baylson, Margaret A1 Kalkstein, Karin A1 Gillespie, Ginger A1 Bellamy, Scarlett L. A1 Fleischman, Joan YR 2009 UL http://www.annfammed.org/content/7/6/527.abstract AB PURPOSE Clinical innovations have made it more feasible to incorporate early abortion into family medicine, yet the outcomes of early abortion procedures in this setting have not been well studied. We wished to assess the outcomes of first-trimester medication and aspiration abortion procedures by family physicians. METHODS Prospective observational cohort study conducted from August 2001 to February 2005 of 2,550 women who sought pregnancy termination in 4 clinical practices of family medicine departments and 1 private office/training site. RESULTS The rate of successful uncomplicated procedures for medication was 96.5% (95% confidence interval [CI], 95.5%–97.0%) and for aspiration was 99.9% (CI, 99.3%–1). Adverse events and complications of medication abortions were failed procedure (ongoing pregnancy; n = 19, 1.45%); incomplete abortion (n = 16, 1.22%); hemorrhage (n = 9, 0.69%); and patient request for aspiration (n = 1, 0.08%). One (0.08%) missed ectopic pregnancy was seen among patients receiving medication. Four types of adverse outcomes were encountered with aspiration: incomplete abortion requiring re-aspiration (n = 21, 1.83%); hemorrhage during the procedure (n = 4, 0.35%); missed ectopic pregnancy (n = 3, 0.26%); and minor endometritis (n = 1, 0.09%). Missed ectopic pregnancies were successfully treated in the inpatient setting without mortality (overall hospitalization rate of 0.16 of 100). All other complications were managed within outpatient family medicine sites. Rates of complication did not vary by experience of physician or by site of care (residency vs private practice). CONCLUSIONS Complications of medication and aspiration procedures occurred at a low rate, and most were minor and managed without incident.