Acceptability and feasibility of phone follow-up with a semiquantitative urine pregnancy test after medical abortion in Moldova and Uzbekistan

Platais, Ingrida; Tsereteli, Tamar; Comendant, Rodica; Kurbanbekova, Dilfuza; Winikoff, Beverly

doi:10.1016/j.contraception.2014.11.004

Cited by 24 publications

(38 citation statements)

References 19 publications

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“…In addition, 88.9% (95% CI: 85.5–91.7) of study participants accurately self-assessed no-ongoing pregnancy (specificity). This is lower than reported for the multi-level urine pregnancy test (MLUPT) [6, 18], but similar to other studies using the LSUPT [4, 13]. …”

Section: Discussionsupporting

confidence: 79%

“…If used, the number of unnecessary clinic follow-up visits could be expected to increase, however this would constitute a small percentage. Critics of the checklist have suggested that providers might simply instruct women to return if they experience pregnancy symptoms or have a positive test [18]; an approach that may be preferred, depending on contextual factors.…”

Section: Discussionmentioning

confidence: 99%

“…Multi-level (hCG detection thresholds >25, >100, >500, >2000 and >10,000 milli-international units/mL) and dual-level low-sensitivity pregnancy tests (hCG detection thresholds >5 and >1000 or >2000 milli-international units/mL), supplemented by checklists have shown promising results in the US [12], Europe [4, 13–16] and some low- and middle income countries [3, 6, 17, 18]. The multi-level test, while highly accurate, involves comparing serial hCG measurements performed at baseline and repeated 7–14 days later [17].…”

Section: Introductionmentioning

confidence: 99%

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Is self-assessment of medical abortion using a low-sensitivity pregnancy test combined with a checklist and phone text messages feasible in South African primary healthcare settings? A randomized trial

et al. 2017

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ObjectiveTo evaluate feasibility of self-assessment of medical abortion outcome using a low-sensitivity urine pregnancy test, checklist and text messages. The study assessed whether accurate self-assessment required a demonstration of the low-sensitivity urine pregnancy test or if verbal instructions suffice.MethodsThis non-inferiority trial enrolled 525 adult women from six public sector abortion clinics. Eligible women were undergoing medical abortion at gestations within 63 days. Consenting women completed a baseline interview, received standard care with mifepristone and home-administration of misoprostol. All were given a low-sensitivity urine pregnancy test and checklist for use 14 days later, sent text reminders, and asked to attend in-clinic follow-up after two weeks. Women were randomly assigned 1:1 to an instruction-only group (n = 262; issued with pre-scripted instructions on the low-sensitivity pregnancy test), or a demonstration group (n = 263; performed practice tests guided by lay health workers). The primary outcome was accurate self-assessment of incomplete abortion, defined as needing additional misoprostol or vacuum aspiration. Analysis was by intention to treat and a non-inferiority margin was set to six percentage points. Women’s acceptability of their abortion procedure and preferences for follow-up were also assessed.ResultsFollow-up was 81% for abortion outcome, confirmed in-clinic at two weeks or self-reported within six months. Non-inferiority of instruction-only to a demonstration was inconclusive for accurate self-assessment (risk difference for instruction-only –demonstration: -2.5%; 95%CI: -9% to 4%). Comparing instruction-only to demonstration groups, 99% and 100% found the pregnancy test easy to do; and 91% and 93% respectively chose the pregnancy test, checklist and text messages for abortion outcome assessment in the future.ConclusionRoutine self-assessment using a low-sensitivity pregnancy test, checklist and text messages is feasible and preferred by women attending South African primary care abortion clinics. Counselling with additional emphasis on prompt recognition of ongoing pregnancies is recommended.Trial registrationClinicalTrials.gov NCT02231619

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is self-assessment of medical abortion using a low-sensitivity pregnancy test combined with a checklist and phone text messages feasible in South African primary healthcare settings? A randomized trial

et al. 2017

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“…Alternatively, telephone follow-up with a home UPT eliminates an in-person visit. Studies have evaluated regimens utilizing telephone evaluation and high-sensitivity UPT [5,6], low-sensitivity UPT [7,8], and semi-quantitative UPT [9,10], and all appear effective in detecting ongoing pregnancies. In the United States, the high-sensitivity UPT is commercially available and can be integrated into clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Comparing office and telephone follow-up after medical abortion

et al. 2016

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“…The multilevel pregnancy test (MLPT) is a promising tool for streamlining the follow‐up of medical abortion . This semiquantitative test comprises a urine dipstick that provides bracketed ranges of human chorionic gonadotropin (hCG) levels.…”

Section: Introductionmentioning

confidence: 99%

Use of an at‐home multilevel pregnancy test and an automated call‐in system to follow‐up the outcome of medical abortion

Anger

Dabash

Peña

et al. 2018

Intl J Gynecology & Obste

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Acceptability and feasibility of phone follow-up with a semiquantitative urine pregnancy test after medical abortion in Moldova and Uzbekistan

Cited by 24 publications

References 19 publications

Is self-assessment of medical abortion using a low-sensitivity pregnancy test combined with a checklist and phone text messages feasible in South African primary healthcare settings? A randomized trial

Is self-assessment of medical abortion using a low-sensitivity pregnancy test combined with a checklist and phone text messages feasible in South African primary healthcare settings? A randomized trial

Comparing office and telephone follow-up after medical abortion

Use of an at‐home multilevel pregnancy test and an automated call‐in system to follow‐up the outcome of medical abortion

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