Synopsis
Surveillance network provides for changes in postabortion care, and is a strategy to improve the access of vulnerable social groups to safe abortion.
Background
Manual vacuum aspiration (MVA) and medical abortion (MA) can be used to treat women with abortion complications and the choice of the evacuation method is essential for the safe management of abortion.
Objective
to evaluate the frequency of use of MVA and MA and investigate the associated factors after the installation of a surveillance network of good practices (MUSA Network) in a university hospital in Brazil.
Methods
A cross-sectional study of women admitted for abortion at UNICAMP Women’s Hospital, Brazil, between July 2017 and November 2020. The dependent variables were the rates of MVA and MA. The independent variables were clinical and sociodemographic data. The Cochran-Armitage test, chi-square test, Mann–Whitney test and multiple logistic regression were used for statistical analysis.
Results
474 women were included. Most women (91.35%) had undergone uterine evacuation: uterine curettage (78.75%), MVA (9.46%) and MA (11.54%). We observed a significant tendency toward an increase in the use of MVA (Z = 9.85; P <0.001). Factors independently associated with performance of MVA were admission in 2020 (OR 64.22; 95% CI 3.79–1086.69) and lower gestational age (OR 0.837; 95% CI 0.724–0.967). The only factor independently associated with MA was a higher level of education (OR 2.66; 95% CI 1.30-5.46).
Conclusion
the use of MVA increased after the installation of a surveillance network for good clinical practices. Being part of networks that encourage the use of evidence-based practices is an opportunity for health facilities to increase access to safe abortions.
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