Title |
Self-administered multi-level pregnancy tests in simplified follow-up of medical abortion in Tunisia
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Published in |
BMC Women's Health, July 2016
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DOI | 10.1186/s12905-016-0327-1 |
Pubmed ID | |
Authors |
Rasha Dabash, Tara Shochet, Selma Hajri, Héla Chelli, Anne-Emmanuele Hassairi, Douha Haleb, Hayet Labassi, Ezzedine Sfar, Fatma Temimi, Leah Koenig, Beverly Winikoff |
Abstract |
This study was conducted to assess the efficacy and acceptability of using a multi-level pregnancy test (MLPT) combined with telephone follow-up for medical abortion in Tunisia, where the majority of providers are midwives. Four hundred and four women with gestational age ≤ 70 days' LMP seeking medical abortion at six study sites were enrolled in this open-label trial. Participants administered a baseline MLPT at the clinic prior to mifepristone administration and were asked to take a second MLPT at home and to call in its results before returning the day of their scheduled follow-up visit 10-14 days later. Almost all women with follow-up (97.1 %, n = 332/342) had successful abortions without the need for surgical intervention. The MLPT worked extremely well among women ≤63 days' LMP in ruling out ongoing pregnancy (negative predictive value (NPV) =100 % (n = 298/298)) and also detecting women with ongoing pregnancies (sensitivity = 100 %; 2/2) as needing follow-up due to non-declining hCG. Among women 64-70 days' LMP, the test also worked well in ruling out ongoing pregnancy (NPV = 96.9 % (n = 31/32) but not as well in terms of sensitivity (50 %), with only one of two ongoing pregnancies detected by MLPT as needing follow-up. Most women (95.1 %) found the MLPT to be very easy or easy to use and would consider using the MLPT again (97.4 %) if needed. Self-administered pre and post MLPT are very easy for women to use and accurate in assessing medical abortion success up to 63 days' LMP. MLPT use for medical abortion follow-up has the potential to facilitate task sharing services and eliminate the burden of routine in-person follow-up visits for the large majority of women. Additional research is warranted to explore the accuracy of the MLPT in identifying ongoing pregnancy among women with gestational ages > 63 days. This study was registered on May 13, 2010, on clinicaltrials.gov as NCT01150279 . |
X Demographics
Geographical breakdown
Country | Count | As % |
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Unknown | 1 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 60 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 14 | 23% |
Researcher | 11 | 18% |
Student > Bachelor | 4 | 7% |
Student > Ph. D. Student | 4 | 7% |
Student > Doctoral Student | 3 | 5% |
Other | 8 | 13% |
Unknown | 16 | 27% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 15 | 25% |
Nursing and Health Professions | 10 | 17% |
Social Sciences | 5 | 8% |
Psychology | 2 | 3% |
Business, Management and Accounting | 2 | 3% |
Other | 7 | 12% |
Unknown | 19 | 32% |