PubMed1996
OBJECTIVE: 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 inquiry was conducted among all individual obstetrically active gynaecologists and all associations/departments of gynaecology in the 21 hospitals in North Holland. The study period covered the years 1990-1994 inclusive. RESULTS: Replies were obtained from 19 associations/departments of the 21 hospitals and from 83% of the obstetrically active gynaecologists (77/93). 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 (44/77). Sixty-eight percent 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 (9/30). A death certificate was issued in 88% of the cases of termination. Sixty-eight percent 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.