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Telephone follow-up and self-performed urine pregnancy testing after early medical abortion: a service evaluation

  • Sharon T. Cameron
    Correspondence
    Corresponding author. Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, NHS Lothian, Royal Infirmary of Edinburgh, Scotland EH16 5SU, UK. Tel.: +44 131 536 2099; fax: +44 131 3536 1609.
    Affiliations
    Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, NHS Lothian, Royal Infirmary of Edinburgh, EH16 5SU, Scotland, UK

    Department of Reproductive and Developmental Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, EH16 5SU, Scotland, UK

    Chalmers Sexual and Reproductive health Service, Edinburgh, EH3 9ES, Scotland, UK
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  • Anna Glasier
    Affiliations
    Department of Reproductive and Developmental Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, EH16 5SU, Scotland, UK
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  • Helen Dewart
    Affiliations
    Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, NHS Lothian, Royal Infirmary of Edinburgh, EH16 5SU, Scotland, UK
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  • Anne Johnstone
    Affiliations
    Department of Reproductive and Developmental Sciences, University of Edinburgh, Royal Infirmary of Edinburgh, EH16 5SU, Scotland, UK

    Chalmers Sexual and Reproductive health Service, Edinburgh, EH3 9ES, Scotland, UK
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  • Audrey Burnside
    Affiliations
    Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, NHS Lothian, Royal Infirmary of Edinburgh, EH16 5SU, Scotland, UK
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      Abstract

      Introduction

      Telephone follow-up with a self-performed low-sensitivity urine pregnancy (LSUP) test was introduced at the Royal Infirmary of Edinburgh, Scotland, as an alternative to routine ultrasonography for confirming successful abortion at 2 weeks following early medical abortion (<9 weeks' gestation). Women who screened ���positive��� at telephone follow-up on the basis of ongoing pregnancy symptoms, scant bleeding or LSUP test result subsequently attended the clinic for a confirmatory ultrasound.

      Methods

      A service evaluation was conducted of the first 8 months of telephone follow-up consisting of a review of the numbers choosing this method of follow-up, the proportion successfully contacted and the efficacy for detecting ongoing pregnancies. In the last 3 months of the study, women were surveyed about their satisfaction with this method of follow-up.

      Results

      Opting for telephone follow-up were 476 out of 619 women (77%). Four women (1%) attended the clinic before telephone follow-up because of pain or bleeding. A total of 410 (87%) of the remaining 472 women were successfully contacted by telephone. Sixty women (15%) screened ���positive���, three of whom had ongoing pregnancies, and one woman falsely screened ���negative���. The sensitivity of the telephone follow-up was 75% [95% confidence interval (CI) 30.1���95.4], and specificity was 86% (95% CI 82.2���89). The negative predictive value was 99.7% (95% CI 98.4���99.9), and positive predictive value was 5% (95% CI 1.7���13.7). All women surveyed (n=75) would recommend telephone follow-up to a friend.

      Conclusion

      A telephone follow-up and an LSUP test at 2 weeks are effective for detecting ongoing pregnancy, have good follow-up rates and are popular choices for women.

      Keywords

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