医学流产后电话随访的可行性。

Feasibility of telephone follow-up after medical abortion.

机构信息

University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Pittsburgh, PA 15213, USA.

出版信息

Contraception. 2010 Feb;81(2):143-9. doi: 10.1016/j.contraception.2009.08.008. Epub 2009 Sep 30.

DOI:10.1016/j.contraception.2009.08.008

PMID:20103453

Abstract

BACKGROUND

This study was conducted to assess the feasibility of using telephone calls combined with high-sensitivity urine pregnancy testing as a primary method of follow-up after medical abortion.

METHODS

We enrolled 139 women up to 63 days of gestation to receive mifepristone 200 mg orally and misoprostol 800 mcg vaginally or buccally, per their choice. Participants were contacted by phone one week after mifepristone administration and interviewed using standardized questions. If the subject or clinician thought the pregnancy was not expelled, the subject returned for an ultrasound examination. Otherwise, subjects performed high-sensitivity home urine pregnancy testing 30 days after the mifepristone and were called within 3 days of the test. Those with positive pregnancy tests returned for an ultrasound examination. Those with negative tests required no further follow-up.

RESULTS

Six of the 139 (4.3%, 95% CI 1.6-9.1%) subjects presented prior to Phone Call 1 for an in-person visit. All 133 (100%, 95% CI 97.8-100%) subjects eligible for their first telephone follow-up were contacted. Eight of the 133 (6.1%, 95% CI 2.6-11.5%) women were asked to return for evaluation and all did so (100%, 95% CI 63.1-100%). Eight of the 133 women eligible for the 30 day phone call presented for an interim visit prior to the call. After 30 days, 116 of the 117 (99.1%, 95% CI 97.5-100%) eligible subjects were contacted. One subject was not reached for the day 30 phone call. Twenty-seven of the 116 (23.3%, 95% CI 15.6-31.0%) subjects had a positive pregnancy test and required follow-up. Two of these subjects (7.4%, 95% CI 1.0-24.2%) did not return for in-person follow-up. Two of the 116 (1.7%, 95% CI 0.2-6.1%) subjects had inconclusive pregnancy tests and were asked to return for follow-up. One of these subjects (50%, 95% CI 1.2-98.7%) did not return. Complete follow-up was achieved in 135 of the 139 subjects (97.1%, 95% CI 94.3-99.9%). None of the 26 women evaluated for a positive or inconclusive pregnancy test had a gestational sac or continuing pregnancy.

CONCLUSION

Telephone follow-up combined with urine pregnancy testing after medical abortion is a feasible alternative to routine ultrasonography or serial serum hCG measurements.

摘要

背景

本研究旨在评估电话随访联合高敏尿妊娠试验作为药物流产后随访的初步方法的可行性。

方法

我们招募了 139 名妊娠 63 天以内的女性，给予米非司酮 200mg 口服和米索前列醇 800μg 阴道或颊黏膜给药，由患者选择。在米非司酮给药后一周通过电话联系患者，并使用标准化问题进行访谈。如果受试者或临床医生认为妊娠未排出，受试者返回进行超声检查。否则，受试者在米非司酮后 30 天进行高敏尿妊娠试验，并在试验后 3 天内进行电话随访。妊娠试验阳性的受试者返回进行超声检查。妊娠试验阴性的受试者无需进一步随访。

结果

在第一次电话随访前，有 6 名（4.3%，95%CI 1.6-9.1%）受试者因个人原因就诊。所有 133 名（100%，95%CI 97.8-100%）符合第一次电话随访条件的受试者均被联系到。在 133 名女性中，有 8 名（6.1%，95%CI 2.6-11.5%）被要求返回进行评估，所有 8 名（100%，95%CI 63.1-100%）均返回。在第一次电话随访前，有 8 名（6.1%，95%CI 2.6-11.5%）133 名符合条件的女性返回进行了临时检查。30 天后，对 117 名（99.1%，95%CI 97.5-100%）符合条件的受试者中的 116 名进行了电话随访。有 1 名受试者无法接听第 30 天的电话。在 116 名有妊娠试验结果的受试者中，有 27 名（23.3%，95%CI 15.6-31.0%）呈阳性，需要随访。在这些受试者中，有 2 名（7.4%，95%CI 1.0-24.2%）未返回进行面对面随访。有 2 名（1.7%，95%CI 0.2-6.1%）受试者妊娠试验结果不确定，被要求返回随访。其中 1 名（50%，95%CI 1.2-98.7%）未返回。在 139 名受试者中，有 135 名（97.1%，95%CI 94.3-99.9%）完成了完整随访。在接受阳性或不确定妊娠试验评估的 26 名女性中，均未发现妊娠囊或持续妊娠。