Brigham and Women's Hospital and the Planned Parenthood League of Massachusetts, Boston, Massachusetts; and Planned Parenthood of New York City, New York, New York.
Obstet Gynecol. 2013 Mar;121(3):607-613. doi: 10.1097/AOG.0b013e3182839fda.
To estimate whether follow-up with serum human chorionic gonadotropin (hCG) results in fewer unplanned visits and interventions than follow-up with ultrasonography.
Women were randomized to either in-clinic serum hCG or ultrasound follow-up after medical abortion. The primary outcome, unplanned interventions and visits, was measured as a composite binary outcome including: additional clinic or emergency room visits, repeat dosing of misoprostol, and surgical evacuation of the uterus. Surveys were administered at initial follow-up and again 1 month after abortion to inquire about unscheduled visits, interventions, and patient satisfaction. Medical records were reviewed for evidence of additional interventions and visits.
A total of 376 patients was randomized. Most participants were white (56%), single (83%), nulliparous (63%), and had completed high school (96%). Average participant age was 26±6 years and average gestational age was 46±6 days. Within 2 weeks of abortion, there was no significant difference in the rate of unplanned interventions and visits between arms, 8.2% (13/159) in the serum hCG arm compared with 6.6% (10/151) in the ultrasound arm (relative risk 1.23, 95% confidence interval [CI] 0.56-2.73, P=.60). By 4 weeks postabortion, 4.4% (6/135) in the ultrasound arm and 1.4% (2/142) in the hCG arm had undergone surgical evacuation (relative risk 0.32, 95% CI 0.07-1.54, P=.16). The majority in both the serum hCG (88%) and ultrasound (95%) arms was satisfied with their assigned follow-up method.
Medical abortion follow-up with serum hCG does not reduce the rate of unplanned interventions and visits compared with ultrasonography. Overall, the number of unplanned interventions is low and both methods of follow-up are acceptable to women.
评估与超声检查相比，人绒毛膜促性腺激素（hCG）血清随访是否会减少计划外就诊和干预次数。
在药物流产后，将女性随机分配至门诊 hCG 血清或超声随访。主要结局（计划外干预和就诊）是一个复合二项结局，包括：额外的诊所或急诊就诊、米索前列醇重复剂量给药和子宫刮宫术。在初始随访时和流产后 1 个月进行调查，以了解非计划性就诊、干预和患者满意度。审查医疗记录以了解额外干预和就诊的证据。
共随机分配了 376 名患者。大多数参与者为白人（56%）、单身（83%）、初产妇（63%）和完成高中学业（96%）。参与者平均年龄为 26±6 岁，平均妊娠龄为 46±6 天。在流产后 2 周内，两组之间的计划外干预和就诊率无显著差异，hCG 组为 8.2%（13/159），超声组为 6.6%（10/151）（相对风险 1.23，95%置信区间 [CI] 0.56-2.73，P=.60）。流产后 4 周时，超声组有 4.4%（6/135）和 hCG 组有 1.4%（2/142）行刮宫术（相对风险 0.32，95%CI 0.07-1.54，P=.16）。hCG 组（88%）和超声组（95%）的大多数患者对其指定的随访方法感到满意。
与超声检查相比，hCG 血清药物流产随访并未降低计划外就诊和干预的发生率。总体而言，计划外干预的数量较少，两种随访方法均被女性接受。
