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RCOG World Congress 2025
June 23 - 25, 2025 | ExCeL London, UK
EP.0008
Enhancing Outpatient Abortion care: A Comprehensive Clinical and Cost-effectiveness Initiative
Part of Topic
Abortion care
Enhancing Outpatient Abortion care: A Comprehensive Clinical and Cost-effectiveness Initiative
Sanjida Mahmood1, Sarojini Burugapalli2
1Basildon University Hospital, Mid and South Essex NHS Foundation Trust, 2 Southend University Hospital, Mid and South Essex NHS Foundation Trust
Introduction
In 2021, over 214,869 abortion procedures were performed in England and Wales, with a notable 17% increase in the first half of 2022. Recognizing the need for a more sustainable, accessible, cost-effective, and stigma-reducing approach, the National Abortion care service proposed transitioning to outpatient settings. This was initially challenging for us at Southend University Hospital but was accelerated by the COVID-19 pandemic. As of April 2020, abortion care services shifted to outpatient clinics. Comprehensive guidelines designed and we collaborated with pharmacy to ensure access to misoprostol TTA packs, provision for same day contraception and Anti-D.
Objectives
Method
Retrospective review of patient records between April 2020 - December 2021. Data collected on demographics, gestational age, contraception and Anti-D provision, sexual screening, major complications, and follow-up or intervention rates.
Results
During this period, 541 women underwent TOP. Majority of TOP were performed before 10 weeks’ gestation with 89.5 % and 9.4% of women having MTOP and MVA respectively. Contraception was provided to 89% of women at discharge. Chlamydia and gonorrhoea screening covered about 93.4% women, with syphilis and HIV screening at 69.5% and 68.9% respectively.
From those who underwent MTOP, no major complications were reported. Out of 20 women with RPOCs, 14 (2.9%) chose surgical management. The transition from inpatient to outpatient care for early medical termination resulted in cost savings of £9,720.
Overall, we noted a 96% success rate in MVA procedures without any major complications, and only 4% requiring further follow-up, without any medical or surgical intervention. Additionally, this led to cost reductions totalling £73,700.
Conclusion
This study concludes that outpatient abortion care is safe and effective, with no increased complications or interventions compared to published standards and significant cost savings. Furthermore, outpatient care service is more convenient.