Safety and acceptability of medical abortion through telemedicine after 9 weeks of gestation: a population-based cohort study.
BJOG
; 126(5): 609-618, 2019 Apr.
Article
em En
| MEDLINE
| ID: mdl-30456778
ABSTRACT
OBJECTIVE:
To assess the safety and acceptability of abortion through telemedicine at >9+0 weeks of gestation.DESIGN:
Cohort study.SETTING:
Poland. POPULATION Six hundred and fifteen women who requested and underwent a abortion through telemedicine from 1 June to 31 December 2016.METHODS:
Risks of adverse outcomes were calculated as adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) by unconditional logistic regression according to gestational age at abortion ≤9 or >9 weeks of gestation. MAIN OUTCOMEMEASURES:
Self-reported clinical visits for complaints related to the abortion within 0-1 days of the treatment, heavy bleeding, pain or bleeding more than expected, and low satisfaction.RESULTS:
Among women undergoing a abortion at ≤9 or >9 weeks of gestation, 3.3 versus 11.7% went to hospital with concerns within 0-1 days of the termination (aOR 3.82, 95% CI 1.90-7.69). Among women undergoing a abortion from 11+1 to 14+2 weeks of gestation, the rate was 22.5% (aOR 9.20, 95% CI 3.58-23.60). Among women undergoing a abortion at ≤9 or >9 weeks of gestation, the rate of heavy bleeding was 6.8 versus 10.1% (aOR 1.65, 95% CI 0.90-3.04), the rate of low satisfaction was 2.4 versus 1.6% (aOR 0.69, 95% CI 0.14-3.36), the rate of bleeding more than expected was 45.6 versus 57.8% (aOR 1.26, 95% CI 0.78-2.02), and the rate of pain more than expected was 35.6 versus 38.8% (aOR 1.11, 95% CI 0.71-1.71).CONCLUSIONS:
Medical abortion through telemedicine at >9 weeks of gestation is associated with a higher risk of same-day or day-after clinical 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. TWEETABLE ABSTRACT A cohort study shows that abortion through telemedicine at >9 weeks of gestation is associated with more hospital visits but not with increased bleeding.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
10_ODS3_salud_sexual_reprodutiva
/
11_ODS3_cobertura_universal
Base de dados:
MEDLINE
Assunto principal:
Hemorragia Uterina
/
Abortivos
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Aborto Induzido
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Telemedicina
/
Assistência ao Convalescente
Tipo de estudo:
Etiology_studies
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Observational_studies
Limite:
Adolescent
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Adult
/
Female
/
Humans
/
Middle aged
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
BJOG
Ano de publicação:
2019
Tipo de documento:
Article