Takeaway
- Medical abortion (MAB) is highly successful and may be successfully followed up with remote/home self-assessment.
Why this matters
- MAB is highly successful; there is a 1% risk of continuing pregnancy after MAB using mifepristone and misoprostol up to 10 weeks of gestation.
- Clinic-based follow-up presents barriers to women and decreases acceptability.
- 80% of women do not attend scheduled follow-up appointments.
Key results
- Outcomes of clinic-based follow-up did not differ from remote/self-assessment.
- Recommendations from guideline committee: women undergoing MAB at home can be offered the choice:
- Self-assessment, including remote assessment, as an alternative to clinic follow-up, or
- Provide women with a low-sensitivity or multilevel urine pregnancy test to exclude ongoing pregnancy.
Study design
- Systematic review and meta-analysis (n=6 studies in final analysis).
- Women undergoing MAB ≤10 weeks 0 days gestation identified.
- In-clinic (ultrasound or measurement of serum human chorionic gonadotropin) and remote/self-assessments (self-performed pregnancy test 1-3 weeks after MAB) for confirming the success of medical abortion compared.
- Funding: National Institute for Health and Care Excellence, UK.
Limitations
- Limitations related to limitations of original studies.
- Studies could not be blinded.
- Timing of remote home pregnancy tests not standardised.
References
References
