141st APHA Annual Meeting

In This section

290227
First-trimester, non-medication abortion-related complication rates: A meta-analysis

Monday, November 4, 2013

E. Angel James, CNM, WHNP-C, MS , Department of Family Health, University of California, San Francisco School of Nursing, San Francisco, CA
Sheila Desai, MPH , Dept. of Obstetrics and Gynecology and Reproductive Sciences, Advancing New Standards in Reproductive health (ANSIRH), Oakland, CA
Diana Taylor, RNP, PhD , Advancing New Standards in Reproductive Health, Bixby Center for Reproductive Health Research & Policy, Oakland, CA
Tracy Weitz, PhD, MPA , Director, Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, San Francisco, CA
Background: Published data on first-trimester, non-medication abortion-related complication rates range widely from 1.3% to 4.4% (+/- 1%). There is also variability in how abortion-related complications are defined across studies. Thus, clinicians' and researchers' ability to evaluate and compare complication rates has been limited. This meta-analysis aims to estimate a mean overall complication rate for first-trimester, non-medication abortions performed by trained clinicians worldwide, and to identify factors (e.g., clinician type, procedure type, obstetric history) that contribute to this rate. Additionally, mean rates of specific complications (e.g., hemorrhage, perforation, infection) will be estimated. Methods: A comprehensive search of PubMed, CINAHL, Web of Science, ScienceDirect, and Medline will be performed to identify published research reporting complication rates of first-trimester, non-medication abortions performed by trained clinicians. Studies reporting data from abortions performed beyond the first-trimester, or studies focusing on interventions to improve complication rates will be excluded. Meta-analytic methods will be used to determine significant predictors of abortion complication rates. Results: Overall and specific mean complication rates will be calculated and the effects of potential predictors will be estimated. Conclusions: We will perform a meta-analytic, systematic review of literature to estimate mean complication rates for first-trimester, non-medication abortions performed by trained clinicians. These rates will be useful in the evaluation of clinical and policy interventions aimed at improving abortion-related patient outcomes. Additionally, identifying factors that contribute to abortion complication rates will help direct future research questions and clinical practice changes.

Learning Areas:
Public health or related nursing
Public health or related research

Learning Objectives:
Identify a mean overall complication rate for first-trimester, non-medication abortions, and discuss factors that contribute to this rate. Identify mean rates of specific abortion-related complications.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an experienced sexual and reproductive health clinician and third-year nursing PhD student at the University of California, San Francisco. My research focuses on unintended pregnancy and the nursing role in unintended pregnancy prevention and abortion care. Additionally, I work as the Clinical Research Consultant on the Health Workforce Pilot Project #171 at Advancing New Standards in Reproductive Health (ANSIRH).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.