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PURPOSE Clinical innovations have made it more feasible to incorporate early abortion into family medicine, yet the outcomes of early abortion procedures in this setting have not been well studied. We wished to assess the outcomes of fi rsttrimester medication and aspiration abortion procedures by family physicians. METHODS RESULTSThe rate of successful uncomplicated procedures for medication was 96.5% (95% confi dence interval [CI], 95.5%-97.0%) and for aspiration was 99.9% (CI, 99.3%-1). Adverse events and complications of medication abortions were failed procedure (ongoing pregnancy; n = 19, 1.45%); incomplete abortion (n = 16, 1.22%); hemorrhage (n = 9, 0.69%); and patient request for aspiration (n = 1, 0.08%). One (0.08%) missed ectopic pregnancy was seen among patients receiving medication. Four types of adverse outcomes were encountered with aspiration: incomplete abortion requiring re-aspiration (n = 21, 1.83%); hemorrhage during the procedure (n = 4, 0.35%); missed ectopic pregnancy (n = 3, 0.26%); and minor endometritis (n = 1, 0.09%). Missed ectopic pregnancies were successfully treated in the inpatient setting without mortality (overall hospitalization rate of 0.16 of 100). All other complications were managed within outpatient family medicine sites. Rates of complication did not vary by experience of physician or by site of care (residency vs private practice). CONCLUSIONSComplications of medication and aspiration procedures occurred at a low rate, and most were minor and managed without incident.

Purpose: To compare outcomes of early medical abortion with mifepristone and misoprostol in a family medicine setting and specialized reproductive health clinics.Methods: This study used data collected from a prospective, open-label, randomized trial of oral versus buccal misoprostol efficacy. A secondary analysis was performed, evaluating efficacy, acceptability, and interventions after medication at the family medicine site compared with the 6 specialized reproductive health sites.Results: Comparing data from patients in the family medicine setting (n ‫؍‬ 116) to specialized reproductive health sites (n ‫؍‬ 731) revealed no difference in overall efficacy (95.7% vs 93.4%; P ‫؍‬ .351). The family medicine site used a second dose of misoprostol more frequently than the other sites (6.9% vs 2.5%; P ‫؍‬ .018). In addition, uterine aspiration after medical abortion at the family medicine site was not used for "medically necessary" reasons whereas reproductive health clinics used it 2.6% of the time (marginally significant; P ‫؍‬ .094). Patient satisfaction at family medicine sites was comparable to the other sites (91.2% vs 92.0%; P ‫؍‬ .792). Conclusion

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