OPEN IN READ APP
JOURNAL ARTICLE

Safety and acceptability of medical abortion by telemedicine above nine gestational weeks: a population-based cohort study

Margit Endler, Leona Beets, Kristina Gemzell, Rebecca Gomperts
BJOG: An International Journal of Obstetrics and Gynaecology 2018 November 19
30456778

OBJECTIVE: To assess the safety and acceptability of abortion through telemedicine > 9 (9+0) gestational weeks (gw).

DESIGN: Cohort study.

SETTING: Poland.

POPULATION: 615 women who requested and performed abortion through telemedicine June 1st- December 31st 2016.

METHODS: Risks of adverse outcomes were calculated as adjusted odds ratios (OR) with 95% confidence intervals (CI) by unconditional logistic regression according to gestational age at abortion ≤ or > 9 gw.

MAIN OUTCOME MEASURES: Self-reported hospital visits for concerns related to the abortion within 0-1 days of the abortion, heavy bleeding, pain and bleeding more than expected and low satisfaction.

RESULTS: Among women ≤ 9gw and >9gw, 3.3% vs 11.7% went to hospital for concerns within 0-1 days of the abortion (AOR 3.82, 95% CI 1.90-7.69). Among women 11w+1d-14w+2d the rate was 22.5% (AOR 9.20, 95% CI 3.58-23.60). Among women ≤ 9gwand > 9 gw, the rate of heavy bleeding was 6.8% vs 10.1% (AOR 1.65, 95% CI 0.90-3.04), the rate of low satisfaction was 2.4% vs 1.6% (AOR 0.69, 95% CI 0.14-3.36), the rate of bleeding more than expected was 45.6% vs 57.8% (AOR 1.26, 95% CI 0.78-2.02), and the rate of pain more than expected was 35.6% vs 38.8% (AOR 1.11, 95% CI 0.71-1.71).

CONCLUSIONS: Medical abortion through telemedicine >9 gw is associated with a higher risk of same-day or day-after hospital visits for concerns related to the procedure and this risk increases with gestational age. Self-reported rates of heavy bleeding, low satisfaction or unmet expectations with medical abortion do not increase with gestational age. This article is protected by copyright. All rights reserved.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
30456778
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"