No test medical abortion - a review of the evidence on selective use of preabortion testing.

Autor:	Cleeve A; Department of Women's and Children's Health, Karolinska Institutet, and the WHO Collaborating Centre for Human Reproduction, Karolinska University Hospital, Stockholm, Sweden.; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden., Wallengren E; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden., Brandell K; Department of Women's and Children's Health, Karolinska Institutet, and the WHO Collaborating Centre for Human Reproduction, Karolinska University Hospital, Stockholm, Sweden., Lee S; Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada., Endler M; Department of Women's and Children's Health, Karolinska Institutet, and the WHO Collaborating Centre for Human Reproduction, Karolinska University Hospital, Stockholm, Sweden.; University of Capetown, Department of Public Health, Capetown, South Africa., Reynolds-Wright J; Centre for Reproductive Health, Institute for Regeneration & Repair, University of Edinburgh, UK Chalmers Centre, NHS Lothian, Edinburgh, UK.
Jazyk:	angličtina
Zdroj:	Current opinion in obstetrics & gynecology [Curr Opin Obstet Gynecol] 2024 Oct 01; Vol. 36 (5), pp. 378-383. Date of Electronic Publication: 2024 Aug 12.
DOI:	10.1097/GCO.0000000000000981
Abstrakt:	Purpose of Review: The last decade has seen a cascade of different telemedicine models for medical abortion (MA) being tested and implemented. Among these service delivery models is the 'no-test' MA model, in which care is provided remotely and eligibility for the MA is based on history alone. The purpose of this review is to provide an overview of the existing evidence for no-test MA. Recent Findings: The evidence base for no-test MA relies heavily on cohort and noncomparative studies predominantly from high resource settings. Recent findings indicate that no-test MA is safe, effective, and highly acceptable. Diagnoses of ectopic pregnancy and underestimation of gestational age were rare. Identified advantages included shortening time to access MA and mitigating access barriers such as cost, and geographical barriers. Abortion seekers valued omitting the ultrasound citing reasons such as privacy concerns, costs, more flexibility, and control. The impacts of no-test MA on unscheduled postabortion contacts and visits and on contraceptive use were unclear due to limited evidence. Summary: No-test MA can be provided to complement other care pathways including those with some or no in-person care. Further research is needed to allow for widespread adoption of no-test MA and scale-up in a variety of contexts, including low-resource settings. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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