Kate Guthrie
Speeches:
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The impact of implants and intrauterine
contraceptives provided at an index surgical
termination of pregnancy (Jan–June 2008) on
repeat termination of pregnancy within 3 years:
an audit
Latham, F1; Guthrie, K2; Trussell, J1
1 Hull York Medical School; 2 Community Health Care Partnership
Hull, UK
Background: Implants and intrauterine contraceptives have lower
failure rates and higher continuation rates than the other
reversible methods of contraception. We hypothesised that the
patients who chose these long lasting reversible methods after
their index surgical termination of pregnancy (STOP) would have
a reduced incidence of subsequent termination of pregnancy
(TOP) in comparison to those who chose other reversible
methods (injections, oral contraceptive pills, patch, ring and
condoms).
Methods: Index cases were recorded retrospectively from theatre
registers at Hull Royal Infirmary for all STOPs between January
and June 2008. Type of contraception chosen at procedure was
recorded: Implanon, Mirena, IUD, Depo-Provera, Sterilisation and
‘Other’ (oral contraceptives, patches, rings, condoms). The
hospital information system for the subsequent 3 years was
searched for another TOP (surgical or medical). The data were
analysed. A secondary objective was to record contraceptive
choices in two age groups (<25 and ‡25 at index STOP).
Results: Women choosing Implanon, Mirena and IUDs had a
significantly lower repeat TOP rate than those choosing other
reversible methods at 2 (3.4% vs. 9.3%, P = 0.008) and 3 (6.8%
vs. 12.4%, P = 0.04) years. As age increased, use after an index
STOP of Implanon decreased (32% vs. 8%) and Mirena increased
(13% vs. 41%) significantly.
Conclusion: A 50% increase in the uptake of implants and
intrauterine contraceptives would decrease the repeat TOP rate
within three years by 16%. -
UK Faculty programme
Katherine Guthrie City Health Care Partnership CIC, Hull, UK - k.guthrie@nhs.net
Training in abortion provision is within the postgraduate specialty training programmes of the Faculty of Sexual and Reproductive Healthcare (FSRH) and the Royal College of Obstetricians and Gynaecologists (RCOG). These cover medical abortion and 1st trimester surgical abortion. The RCOG programme does not cover local anaesthetic procedures. The College has an optional advanced programme to cover local anaesthetic procedures and later gestations for surgery. The Faculty also has a training programme accessible to doctors and nurses who wish to undertake further training in this field. Conscientious objection within the National Health Service plus the shift in the provision of care to non-NHS providers has created a challenge in accessing training.