Effectiveness and acceptability of 'at home' versus 'at hospital' early medical abortion - A lesson from the COVID-19 pandemic: A retrospective cohort study
| Autor: | Dominique A. Badr, Jacques Jani, Iris Mezela, Catherine Van Pachterbeke |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Telemedicine medicine.medical_treatment Gestational sac Abortion Article Pregnancy Health care Medical abortion medicine Humans Pandemics Retrospective Studies Home protocol business.industry Obstetrics SARS-CoV-2 Obstetrics and Gynecology COVID-19 Retrospective cohort study Abortion Induced medicine.disease Hospitals medicine.anatomical_structure Reproductive Medicine Hospital protocol Communicable Disease Control Gestation Female business |
| Zdroj: | European Journal of Obstetrics, Gynecology, and Reproductive Biology |
| ISSN: | 1872-7654 |
| Popis: | Background Since the lockdown caused by the COVID-19 pandemic, restrictions on hospitals' activity forced healthcare practitioners to innovate in order to provide continuity of care to patients. The aim of this study was to evaluate the efficiency of a newly established protocol for medical abortion and to measure the level of satisfaction of the patients who experienced abortion at home. Methods This retrospective study compared all the patients who had an early medical abortion at up to 9 weeks of gestation during the two drastically different periods between December 2018 and March 2021 ("hospital" and "home" groups). We evaluated the expulsion of the gestational sac as a primary outcome. The rates of infection, hemorrhage, retained trophoblastic material and need for surgical management were also assessed. A survey was also used to measure the satisfaction and acceptability of the method. Results The rate of expulsion of pregnancy was not significantly different between the two groups: 92.9% in hospital versus 99% at home. Early retained trophoblastic material and surgical interventions were higher in the hospital group. No significant difference was observed for the remaining outcomes. Moreover, the level of acceptability was similar in both groups, though patients felt safer in the "hospital" group. Conclusion Switching an early medical abortion protocol from expulsion of pregnancy in hospital to expulsion of pregnancy at home is effective and acceptable to women, and may be associated with decreased rate of retained trophoblastic material. Further larger studies are needed to test the long-term result of this protocol. |
| Databáze: | OpenAIRE |
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