Telephone follow-up and self-performed urine pregnancy testing after early medical abortion: a service evaluation

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• 作者：Sharon T. Cameron^a ; ^b ; ^c ; ^{Sharon.cameron@ed.ac.uk} ; Anna Glasier^b ; Helen Dewart^a ; Anne Johnstone^b ; ^c ; Audrey Burnside^a
• 关键词：Abortion ; Medical abortion ; Telephone follow-up ; Ultrasound ; Postabortal
• 刊名：Contraception
• 出版年：2012
• 期刊代码：71_00107824
• 类别：med
• 出版时间：July, 2012
• 卷：86
• 期：1
• 页码：67-73
• 文件大小：146 K

摘要

Introduction

Telephone follow-up with a self-performed low-sensitivity urine pregnancy (LSUP) test was introduced at the Royal Infirmary of Edinburgh, Scotland, as an alternative to routine ultrasonography for confirming successful abortion at 2 weeks following early medical abortion (<9 weeks' gestation). Women who screened 鈥榩ositive鈥?at telephone follow-up on the basis of ongoing pregnancy symptoms, scant bleeding or LSUP test result subsequently attended the clinic for a confirmatory ultrasound.

Methods

A service evaluation was conducted of the first 8 months of telephone follow-up consisting of a review of the numbers choosing this method of follow-up, the proportion successfully contacted and the efficacy for detecting ongoing pregnancies. In the last 3 months of the study, women were surveyed about their satisfaction with this method of follow-up.

Results

Opting for telephone follow-up were 476 out of 619 women (77%). Four women (1%) attended the clinic before telephone follow-up because of pain or bleeding. A total of 410 (87%) of the remaining 472 women were successfully contacted by telephone. Sixty women (15%) screened 鈥榩ositive鈥? three of whom had ongoing pregnancies, and one woman falsely screened 鈥榥egative鈥? The sensitivity of the telephone follow-up was 75%[95%confidence interval (CI) 30.1-95.4], and specificity was 86%(95%CI 82.2-89). The negative predictive value was 99.7%(95%CI 98.4-99.9), and positive predictive value was 5%(95%CI 1.7-13.7). All women surveyed (n=75) would recommend telephone follow-up to a friend.

Conclusion

A telephone follow-up and an LSUP test at 2 weeks are effective for detecting ongoing pregnancy, have good follow-up rates and are popular choices for women.