Comparison of medical abortion follow-up with serum human chorionic gonadotropin testing and in-office assessment.

Abstract:

BACKGROUND:The study was conducted to compare lost to follow-up (LTFU) rates in women having a medical abortion who chose follow-up by in-office ultrasound assessment or serum beta human chorionic gonadotropin (β-hCG) testing. METHODS:This retrospective chart review included 865 women who underwent medical abortion in a free-standing outpatient clinic from September 1, 2007, through September 30, 2010. Patients had a 1-week follow-up evaluation after receiving the medications consisting of in-office ultrasound assessment or serial serum β-hCG testing. Ultrasound assessment was offered throughout the study period, and serum β-hCG testing was offered as of September 1, 2008. Demographic and medical data were reviewed to evaluate LTFU rates based on patient's chosen method of follow-up. Multivariable logistic regression analysis was performed to evaluate factors that were independently associated with lack of follow-up. RESULTS:LTFU rates increased from 18% to 27% in the first and third years of the study period, respectively (p=.009). LTFU rates with ultrasound and β-hCG testing were 22.9% and 33.7%, respectively (p=.024). In multivariable analysis, follow-up method was not associated with increased LTFU. Increased parity, any previous induced abortion, increased distance from home to clinic site and unemployment were independently associated with increased LTFU. CONCLUSIONS:Although LTFU rates are higher with serum β-hCG testing than in-office ultrasound follow-up in our patient population, the women who choose this method are inherently more likely not to follow-up because of other characteristics that predict a high likelihood of being LTFU. Offering serum β-hCG testing does not decrease the LTFU rate in women having a medical abortion.

journal_name

Contraception

journal_title

Contraception

authors

Horning EL,Chen BA,Meyn LA,Creinin MD

doi

10.1016/j.contraception.2011.09.007

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

402-7

issue

4

eissn

0010-7824

issn

1879-0518

pii

S0010-7824(11)00526-9

journal_volume

85

pub_type

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