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Improving clinical practice and service delivery
P133 Unwanted pregnancies after a GU consultation
  1. A De Burgh-Thomas,
  2. K Botly,
  3. G Morris
  1. Gloucestershire Care Services, Gloucester, UK

Abstract

Aims To assess the contraception element of the consultation in patients seen in our GU service.

Objectives To assess the proportion of patients attending for termination that had been seen in the GU service in the year prior. Establish how many of these patients were recorded as having inadequate contraception. The proportion of patients identified as needing enhanced contraception that received any. Establish the accuracy of the GU pregnancy risk assessment.

Methods The 1st arm reviewed the GU notes of the patients that had attended GU within a year of their termination. The 2nd arm reviewed notes from 100 sequential females attending GUM.

Results 67 of 820 (8.2%) women undergoing a TOP had attended GU in the previous year. Seven stated at consultation that they wanted to be pregnant, Three patients attended twice which gives a sample of 63. Retrospective assessment showed that in 8 (13.3.%) pregnancy may have been avoided by intervention in GU. 41 women (41/63)(65.1%) that went on to become pregnant and underwent a termination were identified at their GU visit as either not using any contraception or were relying on condoms that are known to be an inadequate contraceptive choice. This compared to 29% in the general audit of women attending GU. Despite identifying inadequate contraception enhanced contraception was not initiated in any of the patients that went on to become pregnant (1st arm) and in only 7% of the general audit of GU attendees (2nd arm). Concordance between pregnancy assessment recorded in the notes and retrospectively assessed was 43% (1st arm) and 62% (2nd arm) (see abstract P133 table 1).

Abstract P133 Table 1

Contraceptive data collection of BASHH auditable standards

Discussion We demonstrate that 93% of those identified as having urgent contraceptive needs leave without their needs having been addressed. We also demonstrate that contraception compliance is documented poorly. We will discuss changes that we have introduced to meet this service need.

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