Manual Uterine Aspiration: Adding to the Emergency Physician Stabilization Toolkit

Quinley, Kelly E.; Chong, Deborah J. M.; Prager, Sarah; Wills, Charlotte P.; Nagdev, Arun; Kennedy, Sara

doi:10.1016/j.annemergmed.2017.10.019

Cited by 8 publications

(6 citation statements)

References 36 publications

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“…This highlights the need for training providers in remote areas to perform manual uterine aspiration to provide emergency services for patients experiencing complications from an early pregnancy loss or first-trimester medical abortion alike. 33 …”

Section: Discussionmentioning

confidence: 99%

Telemedicine for First-Trimester Medical Abortion in Canada: Results of a 2019 Survey

Renner

Ennis

Kyeremeh

et al. 2023

Telemedicine and e-Health

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Introduction: Telemedicine has the potential to improve abortion access disparities in Canada. We aimed to explore the provision of telemedicine for first-trimester medical abortion and related barriers in 2019. Methods: We conducted a national, cross-sectional, anonymized, web-based survey of clinicians who provided abortion care in 2019 in Canada. We distributed our survey through professional health organizations to maximize identification of possible eligible respondents and used a modified Dillman technique to foster responses. Questions elicited provider demographics, clinical characteristics, including telemedicine first-trimester medical abortion and perceived related barriers. Descriptive statistics were analyzed using R software. Results: Among 465 respondents, 388 reported providing first-trimester medical abortion across Canada; 44.0% reported experience using telemedicine for some components of care: 49.3% of primary care clinicians and 28.7% of specialists. Telemedicine was used for initial consultation (86.0%), prescription (82.2%), or follow-up (92.2%). The median percentage of telemedicine providers' patients who underwent a dating ultrasound was 90.0. The majority usually followed up with patients through quantitative human chorionic gonadotropin (hCG) (84.2%). Seventy-eight percent perceived barriers to telemedicine; the most common being inability to confirm gestational age with ultrasound (43.0%), and lack of provincial telemedicine abortion fee code to pay practitioners (30.2%), timely access to serum hCG testing (24.6%), and nearby emergency services (23.3%). Discussion: In 2019, fewer than half of respondents reported providing some aspects of first-trimester medical abortion through telemedicine and the majority perceived barriers. Our results can inform knowledge translation activities to reduce barriers and increase telemedicine abortion care in Canada.

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Section: Discussionmentioning

confidence: 99%

Telemedicine for First-Trimester Medical Abortion in Canada: Results of a 2019 Survey

Renner

Ennis

Kyeremeh

et al. 2023

Telemedicine and e-Health

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“…For example, real-time gynecological consultations are not always available in many EDs, and ED practitioners are not well trained in how to treat EPL with active management. 9 Understanding how patients with EPL get their care in differing locations and in differing ways suggests a few key opportunities related to training and practice. First, ED physicians can incorporate active EPL management into their practice.…”

mentioning

confidence: 99%

“…Therefore, better and more comprehensive training in the use of manual vacuum aspiration, which is the bedrock of surgical management for EPL, into ED training and practice could lead to not only better preparedness for hemorrhagic emergencies but also to the ability to provide better options for patients who present with stable EPL. 9 Similarly, ED physicians are well positioned to be able to be trained to provide medication management for EPL. Options include combination treatment, which is the most effective (mifepristone and misoprostol), as well as single-agent treatment (misoprostol alone).…”

mentioning

confidence: 99%

“…Doubtless, some of these differences are likely associated with how the health care system is organized. For example, real-time gynecological consultations are not always available in many EDs, and ED practitioners are not well trained in how to treat EPL with active management …”

mentioning

confidence: 99%

“…At baseline, ED physicians need to know how to take care of unstable patients with hemorrhagic shock from EPL without backup from surgical colleagues. Therefore, better and more comprehensive training in the use of manual vacuum aspiration, which is the bedrock of surgical management for EPL, into ED training and practice could lead to not only better preparedness for hemorrhagic emergencies but also to the ability to provide better options for patients who present with stable EPL . Similarly, ED physicians are well positioned to be able to be trained to provide medication management for EPL.…”

mentioning

confidence: 99%

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Variations in Care for Early Pregnancy Loss Across Clinical Settings

Meisel

Schreiber

2023

JAMA Netw Open

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Approximately 1 in 4 women will experience early pregnancy loss (EPL) in her lifetime. After a pregnancy loss, many women will experience psychological sequalae, including higher levels of depression, anxiety, and posttraumatic stress disorder, compared with women who experienced no pregnancy complications. 1 For those who experience EPL, returning some decision-making to the patient for this preference-sensitive condition is important. Treatment options for most forms of EPL include medica- + Related articleAuthor affiliations and article information are listed at the end of this article.

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Manual Uterine Aspiration in the Emergency Department as a First-Line Therapy for Early Pregnancy Loss: A Single-Centre Retrospective Study

Whittaker

Pymar

Liu

2022

Journal of Obstetrics and Gynaecology Canada

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Manual Uterine Aspiration: Adding to the Emergency Physician Stabilization Toolkit

Cited by 8 publications

References 36 publications

Telemedicine for First-Trimester Medical Abortion in Canada: Results of a 2019 Survey

Telemedicine for First-Trimester Medical Abortion in Canada: Results of a 2019 Survey

Variations in Care for Early Pregnancy Loss Across Clinical Settings

Manual Uterine Aspiration in the Emergency Department as a First-Line Therapy for Early Pregnancy Loss: A Single-Centre Retrospective Study

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