[Late pregnancy interruption in Noord-Holland. II. Carefulness before and review afterwards]

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

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

Province of North Holland, The Netherlands.

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.

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.

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.