Late zwangerschapsafbreking in Noord-Holland. II. Zorgvuldigheid vooraf en toetsing achteraf

To gain insight into the carefulness of medical activity in late termination of pregnancy, and into gynaecologists‘ relevant views.

Design

A descriptive, partly cross-sectional, partly retrospective study.

Setting

Province of North Holland, the Netherlands.

Method

An anonymous written enquiry was conducted among all individual obstetrically active gynaecologists and all associationsdepartments of gynaecology in the 21 hospitals in North Holland. The study period covered the years 1990-1994 inclusive.

Results

Replies were obtained from 19 associationsdepartments of the 21 hospitals and from 83 of the obstetrically activ gynaecologists (7793). Activity had been careful in the vast majority (93) of the 103 reported cases of late termination of pregnancy: the diagnosis was definite prenatally and verified postnatally; consultation about termination was conducted in 91; reports were made in all cases. Most responding gynaecologists had performed late termination of pregnancy (4477). Sixty-eight per cent of these were of the opinion that a death certificate had to be issued, as against 30 of those who had not performed late terminations of pregnancy (930). A death certificate was issued in 88 of the cases of termination. Sixtyeight per cent of the respondents with a view to external quality control and subsequent review had opted for a national committee of experts from the profession, in some cases supplemented with experts from outside the profession, plus supervision by the Health Care Inspectorate.

Conclusion

Gynaecologists in North Holland in general acted carefully regarding late termination of pregnancy, although they did not always observe the guidelines issued by their professional association.