Self pregnancy testing in an urban family planning clinic: promising results for a new approach to contraceptive follow-up☆
Received 11 August 2007; received in revised form 17 September 2007; accepted 17 September 2007. published online 22 November 2007.
Refers to erratum:
Erratum to “Self pregnancy testing in an urban family planning clinic: promising results for a new approach to contraceptive follow-up” [Contraception 77 (2008) 40--43]
, 17 April 2008
Christopher M. Estes, Jahanett Ramirez, Lorraine Tiezzi, Carolyn Westhoff
Contraception
June 2008 (Vol. 77, Issue 6, Page 467) Full Text |
Full-Text PDF (54 KB)
Abstract
Background
Immediate initiation of depo-medroxyprogesterone acetate (DMPA) increases continuation and decreases pregnancies compared to conventional (next menstrual period) initiation. A drawback is the need to return in 4 weeks for a repeat pregnancy test to identify any pregnancy that was too early to diagnose on the day of injection. If women can perform home pregnancy tests (HPTs) to detect human chorionic gonadotropin (hCG) in urine, the need for this follow-up visit may be eliminated. This study assesses whether women can perform their own HPT.
Study Design
This is a single-visit observational trial of an HPT kit. Subjects recruited from a waiting room in an urban family planning clinic received an HPT kit with standard instructions to use immediately. Subjects and a research assistant each interpreted the test. Their results were then compared to a standard cassette type test for detection of hCG performed by clinic staff. κ was calculated to assess the level of agreement.
Results
Three hundred ten subjects enrolled. They were young (mean age, 25.2 years), mostly Hispanic (91%) women. A change in the font and explicitness of the instructions decreased the incidence of invalid tests from 12.7% to 4.8%. The subject and research assistant's interpretation of the test had a high level of agreement, κ=0.95 [95% confidence interval (CI), 0.92–0.99]. There was also a high level of agreement between the subjects' results and the standard test, κ=0.88 (95% CI, 0.82–0.95).
Conclusions
Women presenting for pregnancy testing at an urban clinic are able to perform HPTs with a high level of accuracy. The appearance of the instructions influenced the incidence of false-negative and invalid tests. Home pregnancy tests may be useful in follow-up protocols when immediate initiation of DMPA is employed.
aDepartment of Obstetrics and Gynecology, Columbia University, New York, NY 10032, USA
bMailman School of Public Health, Columbia University, New York, NY 10032, USA
Corresponding author. Reproductive Health Services, Department of Obstetrics and Gynecology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA. Tel.: +1 305 325 1455.
☆ The funding support for this study was from an anonymous foundation.
ABSTRACT