Practice makes doctor perfect? Yes, going by high-volume doctors vs low- volume ones

Women health
Women health Pixabay

A new study has found that women whose physicians do not frequently perform surgically induced abortions, have almost twice the risk of severe complications from these operations later on.

Surgically induced abortion or medical termination of pregnancy involves many methods such as aspiration, dilation and evacuation, dilation and extraction among others.

Measured in terms of Physician Procedure Volume or the number of surgically induced abortions performed in the one year period preceding the index procedure date, they're rated as low (< 10th percentile of yearly volume) or higher (≥ 10th percentile). Inevitably, low physician procedure volume is associated with an increased risk of complications after complex surgery for cardiac, cancer and pelvic conditions.

Ning Liu and Joel Ray of the Institute for Clinical Evaluative Sciences (ICES), Toronto, said a physician who performs more procedures regularly is most likely to gain proficiency, as well as the ability to recognize and fix potential problems. "Experience and practice lower the likelihood of major complications," they emphasized.

For the study, Ontario data for over 13 years was used, wherein 529,141 induced surgical abortions performed before 20 weeks' gestation were analysed. They compared low-volume and high-volume physicians' performance.

The result found that severe adverse events occurred in 194 out of 52,889 procedures (3.7 per 1000 procedures) in the low-volume group and in 656 out of 476,252 procedures (1.4 per 1000 procedures) in the higher-volume group.

"Adverse events" in this study include injury to the mother, organ damage, admission to an intensive care unit and, very rarely, death within 42 days of the procedure.

Laura Schummers and Wendy V. Norman from the Department of Family Practice, University of British Columbia suggest that an induced abortion with the nearest provider may be the safest option for a woman with an abnormal or unintended pregnancy, and may call for lower complication rates than delaying an abortion or carrying a pregnancy to birth. They also said carrying a pregnancy to birth carries 8 times higher risk than the abortion care.

This study was published in the journal CMAJ (Canadian Medical Association Journal).