Farooqi Salwa, Lackie Elyse, Pham Alice, Zolis Lynne, Sharma Kalpana, Devarajan Karthika, Smith Kirsten, Nevin-Lam Alexandra, Lee Sabrina, Tempest Heather, Mei-Dan Elad, Tunde-Byass Modupe
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON.
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; North York General Hospital, Toronto, ON.
J Obstet Gynaecol Can. 2025 Apr;47(4):102771. doi: 10.1016/j.jogc.2025.102771. Epub 2025 Jan 23.
Early pregnancy loss (EPL) is a common complication of pregnancy. Research has demonstrated the efficacy of mifepristone pre-treatment followed by misoprostol for the induction of an EPL. North York General Hospital (NYGH) provides an all-in-one Early Pregnancy Assessment Clinic (EPAC) to streamline the care of women with an EPL.
We conducted a prospective single cohort qualitative survey to understand patients' satisfaction with mifepristone and misoprostol and their experience with EPAC at NYGH. We recruited 191 patients with a confirmed EPL. They were given mifepristone and misoprostol. We administered the validated modified version of the Short Form-36 Health Survey Revised quality of life scales questionnaire to study the following outcomes: (1) acceptability of mifepristone and misoprostol: cramping, bleeding, duration of treatment, and recommendation to others; (2) effect on social activities; and (3) participants' overall satisfaction with the EPAC at NYGH.
We found that 96% of our participants responded completely to our questionnaire. For cramping, 24% reported definitely acceptable, whereas 8% definitely unacceptable. For bleeding, 26% reported definitely acceptable, whereas 4.8% definitely unacceptable. For duration of treatment, 27% reported definitely acceptable and 2.7% definitely unacceptable. Finally, for recommendation to others, 41% reported definitely acceptable and 2.1% definitely unacceptable. The rating for NYGH's EPAC was high, with 68% of participants rating it as excellent.
We found that the acceptability of the medical management at our EPAC for an EPL is high with the mifepristone and misoprostol protocol. This study encourages this treatment and the establishment of similar centres.
早期妊娠丢失（EPL）是妊娠常见的并发症。研究已证实米非司酮预处理后联合米索前列醇用于诱导早期妊娠丢失的有效性。北约克综合医院（NYGH）设有一体化的早期妊娠评估诊所（EPAC），以简化对早期妊娠丢失女性的护理。
我们进行了一项前瞻性单队列定性调查，以了解患者对米非司酮和米索前列醇的满意度以及他们在NYGH的EPAC的体验。我们招募了191例确诊为早期妊娠丢失的患者。给他们使用了米非司酮和米索前列醇。我们发放了经过验证的简化版36项健康调查修订版生活质量量表问卷，以研究以下结果：（1）米非司酮和米索前列醇的可接受性：腹痛、出血、治疗持续时间以及向他人推荐的情况；（2）对社交活动的影响；（3）参与者对NYGH的EPAC的总体满意度。
我们发现96%的参与者对问卷做出了完整回复。对于腹痛，24%的人表示完全可以接受，而8%的人表示完全不可接受。对于出血，26%的人表示完全可以接受，而4.8%的人表示完全不可接受。对于治疗持续时间，27%的人表示完全可以接受，2.7%的人表示完全不可接受。最后，对于向他人推荐，41%的人表示完全可以接受，2.1%的人表示完全不可接受。NYGH的EPAC评分很高，68%的参与者将其评为优秀。
我们发现，采用米非司酮和米索前列醇方案，我们的EPAC对早期妊娠丢失进行药物管理的可接受性很高。本研究鼓励采用这种治疗方法并建立类似的中心。
