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基于半定量妊娠检测的简化医学流产:家庭随访方案。

Simplified medical abortion using a semi-quantitative pregnancy test for home-based follow-up.

机构信息

Stanford University Medical Center, Stanford, USA.

出版信息

Int J Gynaecol Obstet. 2013 May;121(2):144-8. doi: 10.1016/j.ijgo.2012.11.022. Epub 2013 Mar 7.

Abstract

OBJECTIVE

To simplify follow-up after medical abortion by examining whether women could use a semi-quantitative pregnancy test at home to screen for ongoing pregnancy.

METHODS

Three hundred women seeking medical abortion at a tertiary hospital in Vietnam participated in the study. Participants used a semi-quantitative pregnancy test at the hospital to estimate baseline human chorionic gonadotropin (hCG) levels and administered another test at home 2 weeks later for comparison. Women interpreted the test result at home and then returned to hospital for follow-up care. At this visit, self-assessment was verified. To assess further the feasibility of the test as a follow-up tool in service delivery, 200 additional women completed a user comprehension survey.

RESULTS

The tests identified all 11 ongoing pregnancies among study participants (100% sensitivity; 89.7% specificity). Women reported that the test was easy to use (255/292 [87.3%]) and that provider instructions helped them to use the test (291/292 [99.7%]).

CONCLUSION

Semi-quantitative pregnancy tests offer high sensitivity and negative predictive value. If user instructions can be further simplified, the tests could be used in lieu of transvaginal ultrasound and/or serum hCG at clinic-based follow-up or by women themselves for home-based follow-up. Clinical trials.gov:NCT01150279.

摘要

目的

通过检查女性是否可以在家使用半定量妊娠试验来筛查持续性妊娠,从而简化药物流产后的随访。

方法

300 名在越南一家三级医院寻求药物流产的女性参与了这项研究。参与者在医院使用半定量妊娠试验来估计基线人绒毛膜促性腺激素(hCG)水平,并在 2 周后在家中进行另一次测试进行比较。女性在家中解读测试结果,然后返回医院进行随访。在此次就诊时,对自我评估进行了验证。为了进一步评估该试验作为服务提供中随访工具的可行性,另外 200 名女性完成了用户理解调查。

结果

试验识别出研究参与者中的所有 11 例持续性妊娠(100%的敏感性;89.7%的特异性)。女性报告说该试验易于使用(255/292[87.3%]),并且提供者的说明帮助她们使用了该试验(291/292[99.7%])。

结论

半定量妊娠试验具有较高的敏感性和阴性预测值。如果可以进一步简化用户说明,那么该试验可以替代基于诊所的随访中的阴道超声和/或血清 hCG,或者供女性自己在家中进行随访。Clinical trials.gov:NCT01150279。

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