S508 Free communication (oral) presentations/International Journal of Gynecology & Obstetrics 119S3 (2012) S261–S530 in October 2007, aimed to primary prevention through quadrivalent HPV vaccine and to secondary prevention of cervical lesions in women aged 12–26 years. Methods: At first visit, patients received individual counseling by the clinic personnel, with great care about privacy issues, and were addressed to vaccination or pre-vaccination screening procedure. Pre-vaccination screening (pelvic examination, Pap test), in sexually active girls was performed after examining the main risk factors by self-administered questionnaire. Results: In our 4-year experience (October 2007 to November 2011) a total of 597 young women were vaccinated. The average age was 18.5 years (sd 3.5). The 39.4% (233) of the vaccinated population claimed to be sexually active. The average age at first intercourse was 17.2 years (sd 2.2). Among the 233 sexually active girls, 119 (51.2%) reported sex with only one partner, 94 (40.5%) with 2 to 4 partners, 19 (8.2%) with more than 4 partners. About cigarette smoking, the 28.4% of vaccinated girls declared to be smokers. Considering the use of contraceptives, 57.51% of the vaccinated population declared use of contraceptive methods, of which 57.46% using the pill and 26.87% using condoms. Only minor adverse events were reported, more frequently reactions in the injection site. Since October 2009, the PreGIO Outpatient Clinic offered to sexually active vaccinated women the opportunity of a colpo- cytologic follow-up visit a year after the third dose of vaccine. This was performed in 66 women (mean age 22.4), among which 6 (9.1%) showed cytologic alterations (≤ L-SIL) with minor colposcopic changes; all the 3/6 cases tested for HPV DNA resulted negatives for HPV 6, 11, 16 e 18. Conclusions: The activity of PreGIO was successful, as shown by the number of subjects vaccinated (597) and by the compliance to vaccination. We can point out the good tolerability of vaccine. An appropriate individual pre-vaccination counseling contributed to the acceptance of an outpatient clinic that deals with girls of such a critical age. O703 EVALUATION OF ABORTION SERVICES AND PATIENT CHARACTERISTICS IN A MEXICO CITY PUBLIC HOSPITAL AFTER LEGALIZATION T.M. Palermo 2 , E. Troncoso 1 , R. Schiavon 1 , P. Sanhueza 3 , R. Meiner Huebner 3 . 1 IPAS, Mexico DF, Mexico; 2 Department of Preventive Medicine, State University of New York, Stony Brook, NY, United States; 3 Secretaria de Salud del Distrito Federal, Distrito Federal, Distrito Federal, Mexico Objectives: In April 2007, Mexico City legalized first trimester abortion, and the District’s Ministry of Health facilities rapidly accommodated the immediate demand for services. We performed a retrospective study of abortion cases from one facility in the twelve-month period post-legalization and then again for five months three years later in 2011, to study quality of care and patient characteristics. Materials: We described socioeconomic and demographic characteristics of patients, abortion technology used, provision of pain management, postabortion contraceptive uptake, and information on total costs paid. Methods: We performed bivariate analysis to investigate differences in technology used, pain management, costs paid, and postabortion uptake by residence, age, and income of patients using chi-squared tests for categorical outcomes and t-tests for continuous outcomes. Results: Women receiving abortion services were typically residents of Mexico City, single, nulliparous, highly educated and in their early twenties. Seventy-nine and 96.1 percent of abortions were performed with WHO-recommended technologies in periods one and two, respectively, indicating improvement over time. Pain management was used in 85 and 100 percent of procedures in periods one and two, respectively. Seventy-eight percent of women received a contraceptive method postabortion in period one and 51.3 percent did so in period two. Minors had higher average gestational age than older women, and differences were also seen by income. Women residing outside of Mexico City were more likely to obtain abortions where the technology used was surgical (instead of medical abortion) compared to women living in Mexico City. General anesthesia was more often used for sharp curettage procedures, and average costs paid by women were highest for medical abortion, despite its being the least labor intensive method for hospital personnel. Conclusions: The study hospital was able to provide high quality abortion services after legalization, though improvements should continue to be made in the areas of abortion technology used and postabortion contraceptive uptake. Comprehensive training is a pivotal piece to improve abortion services in context with changes on the legal regulations O704 MATERNAL NEAR MISS: RESULTS FROM A HOSPITAL-BASED STUDY IN ACCRA, GHANA O. Tuncalp 1 , M. Hindin 1 , K. Adu-Bonsaffoh 2 , R. Adanu 3 . 1 Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Washington, DC, United States; 2 University of Ghana Medical School, Accra, Ghana; 3 School of Public Health, University of Ghana, Accra, Ghana Objectives: Maternal morbidity carries a high global burden, especially in developing countries. The identification of cases of severe maternal morbidity has emerged as a promising complementary or alternative strategy to the measurement of maternal mortality. By utilizing WHO near-miss approach we aim to: 1) calculate the incidence and evaluate the management of severe maternal morbidities, 2) analyze the risk factors for maternal near miss in our study population, and 3) explore the feasibility of collecting surveillance data on severe maternal morbidities in a sub-Saharan African setting with high maternal mortality burden. Materials: The data collection was prospective and took place between October 2010 and March 2011 in a teaching hospital in Accra, Ghana. Methods: A modified WHO maternal near-miss tool was used to collect data among all delivering women at the facility. The questions included demographic characteristics, maternal/perinatal information, process indicators and near miss screening questions. Results: Our study population included 3439 women, 3206 live births and 324 stillbirths. The maternal mortality ratio was 1185 per 100,000 live births during the study period. Maternal near miss rates for disease-specific, intervention-specific and WHO criteria were 11.4, 12.2 and 2.9 per 100 live births, respectively. The most common disease-specific near miss events were severe preeclampsia (60%), followed by severe postpartum hemorrhage (27%), whereas the most commonly identified organ dysfunctions were coagulation/hematologic (50%) and cardiovascular (25%). After multivariate adjustment, gestational age and final mode of delivery remained significantly associated with being a near-miss case. Two thirds of our study population were referrals and near-miss cases and maternal deaths were twice and five times more likely to be referred, respectively. Moreover, only 17% of the near miss cases had access to ICU with an overall ICU admission rate of 0.7%. Conclusions: Our results suggest that with sufficient capacity building within the facility, it is feasible to collect data prospectively using WHO criteria in a Sub-Saharan African facility setting, thus, to systematically identify roadblocks to improve maternal health care. In our facility, severe maternal outcomes can be potentially reduced by implementing the use of evidence-based interventions, improving referral systems and the availability and use of critical care.