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Self-administered multi-level pregnancy tests in simplified follow-up of medical abortion in Tunisia

Dabash, Rasha ; Shochet, Tara ; Hajri, Selma ; Chelli, Héla ; Hassairi, Anne-Emmanuele ; Haleb, Douha ; Labassi, Hayet ; Sfar, Ezzedine ; Temimi, Fatma ; Koenig, Leah ; Winikoff, Beverly

BMC women's health, 2016-07-30, Vol.16 (1), p.49-49 [Peer Reviewed Journal]

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Title:
Self-administered multi-level pregnancy tests in simplified follow-up of medical abortion in Tunisia
Author: Dabash, Rasha ; Shochet, Tara ; Hajri, Selma ; Chelli, Héla ; Hassairi, Anne-Emmanuele ; Haleb, Douha ; Labassi, Hayet ; Sfar, Ezzedine ; Temimi, Fatma ; Koenig, Leah ; Winikoff, Beverly
Subjects: Aftercare - methods ; Prospective Studies ; Humans ; Middle Aged ; Misoprostol - pharmacology ; Self Administration - standards ; Pregnancy Tests - methods ; Gestational Age ; Abortion, Induced ; Pregnancy ; Health Education - standards ; Self Administration - methods ; Health Education - methods ; Adolescent ; Adult ; Female ; Mifepristone - pharmacology ; Pregnancy Tests - standards ; Tunisia ; Mifepristone - therapeutic use ; Misoprostol - therapeutic use ; Usage ; Diagnosis ; Pregnant women ; Health aspects ; Abortion ; Index Medicus
Is Part Of: BMC women's health, 2016-07-30, Vol.16 (1), p.49-49
Description: 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 .
Publisher: England: BioMed Central Ltd
Language: English
Identifier: ISSN: 1472-6874
EISSN: 1472-6874
DOI: 10.1186/s12905-016-0327-1
PMID: 27475998

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Self-administered multi-level pregnancy tests in simplified follow-up of medical abortion in Tunisia

Dabash, Rasha ; Shochet, Tara ; Hajri, Selma ; Chelli, Héla ; Hassairi, Anne-Emmanuele ; Haleb, Douha ; Labassi, Hayet ; Sfar, Ezzedine ; Temimi, Fatma ; Koenig, Leah ; Winikoff, Beverly

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