Document Detail


Unexpected heaping in reported gestational age for women undergoing medical abortion.
MedLine Citation:
PMID:  19698823     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In August 2006, the Planned Parenthood Federation of America (Planned Parenthood) conducted an extensive audit of first-trimester medical abortions with oral mifepristone plus buccal misoprostol through 56 days of gestation so that patients could be given accurate information about the success rate of the new regimen.
OBJECTIVES: We sought to evaluate the effectiveness of this buccal misoprostol regimen and to examine correlates of its success during routine service delivery.
METHODS: Audits in 10 large urban service points were conducted in 2006 to estimate the success rates of the buccal regimen. Success was defined as medical abortion without vacuum aspiration.
RESULTS: We discovered unexpected heaping of reported gestational age (GA) on days divisible by 7.
CONCLUSION: Such heaping, which has not been reported in the literature, would make it more difficult to detect a modest trend in declining effectiveness with increasing GA, if there were one. High coefficients of variation of sac size and crown-rump length characterize the early gestational weeks. We suspect, but are unable to prove, that the source of the heaping found in our investigation is a tendency for operators of ultrasound machines at some sites to simplify reporting by rounding a portion of the results to a date corresponding to the nearest complete gestational week. We believe that immediate supervisory awareness and feedback may reduce the extent of the problem. However, the problem may persist in multiple-site studies given the underlying variability of ultrasound measurements with differently calibrated machines and different rules for recording data, some of which may permit acceptance of an estimate based on the stated date of the last menses, if it differs by no more than 2 or 3 days from the ultrasound result.
Authors:
Irving Sivin; James Trussell; E Steve Lichtenberg; Mary Fjerstad; Kelly Cleland; Vanessa Cullins
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Publication Detail:
Type:  Journal Article     Date:  2009-05-09
Journal Detail:
Title:  Contraception     Volume:  80     ISSN:  1879-0518     ISO Abbreviation:  Contraception     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-24     Completed Date:  2009-12-11     Revised Date:  2011-09-02    
Medline Journal Info:
Nlm Unique ID:  0234361     Medline TA:  Contraception     Country:  United States    
Other Details:
Languages:  eng     Pagination:  287-91     Citation Subset:  IM    
Affiliation:
Reproductive Health Program, Population Council, New York, NY 10065, USA. isivin@popcbr.rockefeller.edu
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MeSH Terms
Descriptor/Qualifier:
Abortifacient Agents, Nonsteroidal / administration & dosage
Abortifacient Agents, Steroidal / administration & dosage
Abortion, Induced / methods*
Female
Gestational Age*
Humans
Mifepristone / administration & dosage
Misoprostol / administration & dosage
Pregnancy
Ultrasonography, Prenatal / methods*
Urban Population
Grant Support
ID/Acronym/Agency:
R24 HD047879-05/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Abortifacient Agents, Nonsteroidal; 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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