Pain perceived during drug-induced abortion in general practice: evaluation and predictive factors

Introduction. In metropolitan France and in Reunion Island, the proportion of drug-induced abortions performed in general practice has increased since 2004. The lack of research on this subject, the procedure taking place at the patient's home and the high number of patients lost to follow-up after abortion result in a limited knowledge of the perceived pain and the relevant factors influencing it. Aims. To measure the perceived pain of patients undergoing drug-induced abortion in general practice. To identify predictive factors of pain, to study prescription of analgesics by physicians and to compare it with analgesics consumed by patients. Method. Descriptive cross-sectional study including 134 patients performing drug-induced abortion in general practice, from 01/09/2018 to 31/01/2019. The data collection, conducted by phone survey 2 to 4 days after the misoprostol administration, concerned the pain perceived by the patients, the analgesics prescribed by the physicians and those consumed by the patients. Risk factors for high pain were assessed by bi- and multivariate analysis. Results. One-third of the patients reported maximum pain of more than 7/10 and three-quarters of them more than 4/10. This pain lasted for more than one hour in 53.5% of cases. Fewer than half of the patients used curative analgesics and only 5% used level 2 analgesics. These were prescribed by only one-third of the physicians. Nulliparity and severe algomenorrhea were risk factors for higher pain. Conclusion. Systematic prescription of analgesics and preventive analgesia, as well as special attention to higher-risk patients, could improve the management of pain.