UK: A ‘fast-track’ referral service for intrauterine contraception following early medical abortion

This study found that only half the women fast-tracked for intrauterine contraception actually attended and these tended to be women who were pre-existing clients of the family planning clinic. From Journal of Family Planning and Reproductive Health Care.

The authors note that a ‘fast-track’ referral system for intrauterine contraception was established in 2007 between the medical abortion service at the Royal Infirmary of Edinburgh and the principal family planning clinic (FPC) in Edinburgh.

This was case note review of women fast-tracked for intrauterine contraception after medical abortion between January 2007 and June 2009. The main outcome measures were numbers of women referred, attendance rates, interval to insertion, devices chosen and known complication rates.

Of the 237 women referred, 126 (53%) attended for intrauterine contraception insertion. Attenders were slightly but significantly older than non-attenders (mean ages of 30 and 27 years, respectively; p=0.003), less likely to live in an area of deprivation (p=0.045) and were significantly more likely to have attended the FPC in the past (p<0.0001). Most attenders (90%; n=113) proceeded to have an intrauterine method inserted; 57% (n=64) chose the levonorgestrel intrauterine system and 43% (n=49) chose a copper intrauterine device. The median interval to insertion was 21 (range 0-54) days.

Of those women (n=55) who attended for routine follow-up 6 weeks later (49%), there were four (7.2%) cases of expulsion, two (3.6%) requests for removal and four (7.2%) cases of suspected infection.

The authors concluded that only half the women fast-tracked for intrauterine contraception actually attended and these tended to be women who were pre-existing clients of the FPC. Consideration should therefore be given to provision of immediate insertion where possible.

Consultant Gynaecologist, Chalmers Sexual and Reproductive Health Service, NHS Lothian, Edinburgh; Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh; and Department of Reproductive and Developmental Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.

Assessment of a ‘fast-track’ referral service for intrauterine contraception following early medical abortion. Cameron ST, Berugoda N, Johnstone A, Glasier A. Journal of Family Planning and Reproductive Health Care. 2012 Jan 31. [Epub ahead of print]

Source: http://www.abortionreview.org