| Alternatives to a routine follow-up visit for early medical abortion. | |
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MedLine Citation:
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PMID: 20093898 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the ability of women and their providers to assess abortion outcome without the routine use of ultrasonography. METHODS: This multicenter trial enrolled 4,484 women seeking medical abortion at 10 clinics in the United States. Women received the standard medical abortion care with mifepristone-misoprostol in those clinics and blinded clinical assessments before follow-up ultrasonography. Data were collected prospectively on abortion outcomes, receipt of additional treatment, and clinical, laboratory, and ultrasound assessments associated with the procedure. We constructed five model algorithms for evaluating women's postabortion status, each using a different assortment of data. Four of the algorithms (algorithms 1-4) rely on data collected by the woman and on the results of the low-sensitivity pregnancy test. Algorithm 5 relies on the woman's assessment, the results of the pregnancy test, and follow-up physician assessment (sometimes including bimanual or speculum examination). RESULTS: A total of 3,054 women received medical abortion and had adequate data for evaluation. Twenty women (0.7%) had an ongoing pregnancy; 26 (0.9%) received curettage for retained tissue, empiric treatment for possible infection, or both; and 55 (1.8%) received additional uterotonics or other medical abortion-related care. Screening algorithms including patient-observed outcomes, a low-sensitivity pregnancy test, and nonsonographic clinical evaluation were as effective as sonography in identifying women who received interventions at or after the follow-up visit. CONCLUSION: Relying on women's observations, a low-sensitivity pregnancy test, and clinical examination, women and their providers can accurately assess whether follow-up care is required after medical abortion without routine ultrasonography. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00120224. LEVEL OF EVIDENCE: II. |
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Authors:
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Wesley Clark; Hillary Bracken; Jini Tanenhaus; Suzanne Schweikert; E Steve Lichtenberg; Beverly Winikoff |
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15214948 - Cytogenetic abnormalities in products of conception: a relationship revisited. 10370848 - Office management of early induced abortion. 638578 - Spontaneous abortion and fetal abnormality in subsequent pregnancy. 11846708 - Induced abortion and placenta complications in the subsequent pregnancy. 444358 - Pituitary tumours during pregnancy in mothers treated with bromocriptine. 8001868 - Distention of the uterus activates its multiple pacemakers and induces their coordination. |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 115 ISSN: 1873-233X ISO Abbreviation: Obstet Gynecol Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-01-22 Completed Date: 2010-02-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 264-72 Citation Subset: AIM; IM |
Affiliation:
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Gynuity Health Projects, New York, New York, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00120224 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abortifacient Agents, Steroidal
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administration & dosage Abortion, Induced* Adult Continuity of Patient Care Female Humans Mifepristone / administration & dosage Misoprostol / administration & dosage Pregnancy Pregnancy Trimester, First Uterus / ultrasonography |
| Chemical | |
Reg. No./Substance:
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0/Abortifacient Agents, Steroidal; 59122-46-2/Misoprostol; 84371-65-3/Mifepristone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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