Use of medications to decrease bleeding during surgical abortion: a survey of abortion providers' practices in the United States.

OBJECTIVE

Our objective was to document current practices of abortion providers on the use of medications to decrease bleeding during surgical abortion.

STUDY DESIGN

We emailed surveys to 336 abortion providers through a professional listserv to elicit information on their use of medications to prevent and treat bleeding during first- and second-trimester surgical abortion.

RESULTS

One hundred sixty-eight (50%) providers responded to our survey. The majority were obstetrician-gynecologists (83%) working in an academic practice (66%). Most completed a fellowship in family planning (87%) and currently perform abortions up to 22 or 24weeks of gestation (63%). Seventy-two percent routinely used prophylactic medications for bleeding. Providers who routinely used medications to prevent bleeding most commonly chose vasopressin (83%). Providers preferred methylergonovine as a treatment for excessive bleeding in the second trimester, followed by misoprostol.

CONCLUSION

We found that most providers routinely use medications to prevent bleeding and use several different regimens to treat bleeding during abortion.

IMPLICATIONS

We found that surgical abortion providers use a range of medications to prevent and treat hemorrhage at the time of surgical abortion. Scant evidence is available to guide abortion providers on the use of medications to decrease hemorrhage during surgical abortion. To provide evidence-based recommendations for the prevention and treatment of clinically significant bleeding, researchers should target the most commonly used interventions.