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Roberge, Suzanne

Introduction: The combination Mifepristone and Misoprostol for medical abortion of early first-trimester pregnancy has been approved by Health Canada since 2016. However, numerous medical visits and ultrasound requirements remain barriers to patient care, especially in remote areas. Aim: This study aimed to identify clinical indicators to inform the development of a clinical follow-up checklist in order to safely remove the actual constraint of an ultrasound scan that confirms the success of the medical abortion for patients at less than 64 days of gestational age. Results: A prospective cohort study was conducted from January 1st, 2023, to December 31st, 2023. A total of 76 patients were initially evaluated for medical termination of pregnancy. Telephone clinical evaluation was planned after the mifepristone and misoprostol regimen and before the scheduled ultrasound visit. The success rate was calculated at 88 % - 95 %, if we consider only one dose of misoprostol or success without a surgical procedure. For the group with pre-clinical and post-US complete data (n=40), the sensitivity and negative predictive value to identify patients with a complete medical abortion who did not need an ultrasound were respectively 84 % and 87 %. Conclusion: Medical termination of an unplanned pregnancy is a very personal choice, and treatment needs to be individualized. Replacing post-abortion in-person visit by a telephone FU using a checklist of symptoms and signs is a safe alternative in our FP clinic and will increase access to care.

Text

University of British Columbia. SURG 560

Vancouver : University of British Columbia Library

10.14288/1.0441991

Medicine, Faculty of

Unreviewed

http://creativecommons.org/licenses/by-nc-nd/4.0/