{"id":7530,"date":"2021-10-01T10:23:24","date_gmt":"2021-10-01T08:23:24","guid":{"rendered":"https:\/\/www.site.cidsr.md\/?page_id=7530"},"modified":"2021-10-12T10:53:31","modified_gmt":"2021-10-12T08:53:31","slug":"implicatiile-de-ordin-clinic-si-de-deservire-in-cazul-omiterii-ultrasonografiei-inainte-de-avort-medicamentos-administrat-direct-pacientei-prin-serviciul-de-telemedicina-si-prin-posta","status":"publish","type":"page","link":"https:\/\/www.site.cidsr.md\/en\/implicatiile-de-ordin-clinic-si-de-deservire-in-cazul-omiterii-ultrasonografiei-inainte-de-avort-medicamentos-administrat-direct-pacientei-prin-serviciul-de-telemedicina-si-prin-posta\/","title":{"rendered":"Clinical and Service Delivery Implications of Omitting Ultrasound Before Medication Abortion Provided Via Direct-to-Patient Telemedicine and Mail"},"content":{"rendered":"<p><span style=\"font-size: 10pt;\"><img loading=\"lazy\" src=\"https:\/\/www.site.cidsr.md\/wp-content\/uploads\/2021\/10\/Clinical-and-service-delivery-implications.png\" alt=\"\" class=\"wp-image-7531 alignright\" width=\"564\" height=\"262\" srcset=\"https:\/\/www.site.cidsr.md\/wp-content\/uploads\/2021\/10\/Clinical-and-service-delivery-implications.png 945w, https:\/\/www.site.cidsr.md\/wp-content\/uploads\/2021\/10\/Clinical-and-service-delivery-implications-300x139.png 300w, https:\/\/www.site.cidsr.md\/wp-content\/uploads\/2021\/10\/Clinical-and-service-delivery-implications-768x357.png 768w\" sizes=\"(max-width: 564px) 100vw, 564px\" \/>Anger, H.A., Raymond, E.G., Grant, M., Haskell, S., Boraas, C., Tocce, K., Banks, J., Coplon, L., Shochet, T., Platais, I., Winikoff, B.<\/span><br \/>\n<span style=\"font-size: 10pt;\">Contraception; July 27, 2021; Article in Press; doi: <a href=\"https:\/\/doi.org\/10.1016\/j.contraception.2021.07.108\">https:\/\/doi.org\/10.1016\/j.contraception.2021.07.108<\/a>\u00a0 <\/span><\/p>\n<p><strong>ABSTRACT<\/strong><\/p>\n<p><strong><span>Objectives:<\/span><\/strong><span> To compare outcomes among patients who did or did not have pre-abortion ultrasound or pelvic exam before obtaining medication abortion (MA) via direct-to-patient telemedicine and mail.<\/span><\/p>\n<p><strong><span>Study Design:<\/span><\/strong><span> We analyzed data from participants screened for enrollment into the TelAbortion study at five sites from March 25-September 15, 2020. We compared participants who had pre-abortion ultrasound or pelvic exam (\u201ctest-MA\u201d) to those who did not (\u201cno-test MA\u201d). Outcomes were: abortion not complete with pills alone (i.e. had procedure intervention or ongoing pregnancy), ongoing pregnancy separately, ectopic pregnancy, hospitalization and\/or blood transfusion, and unplanned clinical encounters. We used propensity score weighting and multivariable logistic regression to adjust for baseline characteristics.<\/span><\/p>\n<p><strong><span>Results:<\/span><\/strong><span> Our analysis included 287 participants who had no-test MA and 125 who had test-MA. Abortion was not complete with pills alone in 16\/287 (5.6%) no-test MA patients compared to 2\/123 (1.9%) test-MA patients (adjusted risk difference [aRD]=4.3%, 95% confidence interval [CI]: 1.4-7.1%). No ectopic pregnancies were detected. Groups did not differ regarding hospitalization and\/or blood transfusion (p=0.76) or ongoing pregnancy diagnosis (p=0.59). Unplanned clinical encounters were more common in no-test MA patients (35\/287, 12.5%) than test-MA patients (10\/125, 8.0%, aRD=6.7%, 95% CI: 0.5-13.1%).<\/span><\/p>\n<p><strong><span>Conclusions:<\/span><\/strong><span> Compared to patients who had pre-abortion ultrasound, patients who had no-test MA via telemedicine were more likely to have abortions that were not complete with pills alone and\/or unplanned clinical encounters. However, both no-test and test-MA patients had similar and very low rates of ongoing pregnancy and hospitalization or blood transfusion.<\/span><\/p>\n<p><strong><span>Implications:<\/span><\/strong><span> Omitting pre-abortion ultrasound before provision of medication abortion via telemedicine does not appear to compromise safety or result in more ongoing pregnancies. However, compared to patients who have pre-abortion ultrasound, patients who do not have pre-abortion tests may be more likely to seek post-treatment care and have procedural interventions.<\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>Anger, H.A., Raymond, E.G., Grant, M., Haskell, S., Boraas, C., Tocce, K., Banks, J., Coplon, <a class=\"read-more\" href=\"https:\/\/www.site.cidsr.md\/en\/implicatiile-de-ordin-clinic-si-de-deservire-in-cazul-omiterii-ultrasonografiei-inainte-de-avort-medicamentos-administrat-direct-pacientei-prin-serviciul-de-telemedicina-si-prin-posta\/\">more>><\/a><\/p>\n","protected":false},"author":2,"featured_media":7531,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.site.cidsr.md\/en\/wp-json\/wp\/v2\/pages\/7530"}],"collection":[{"href":"https:\/\/www.site.cidsr.md\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.site.cidsr.md\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.site.cidsr.md\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.site.cidsr.md\/en\/wp-json\/wp\/v2\/comments?post=7530"}],"version-history":[{"count":5,"href":"https:\/\/www.site.cidsr.md\/en\/wp-json\/wp\/v2\/pages\/7530\/revisions"}],"predecessor-version":[{"id":7536,"href":"https:\/\/www.site.cidsr.md\/en\/wp-json\/wp\/v2\/pages\/7530\/revisions\/7536"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.site.cidsr.md\/en\/wp-json\/wp\/v2\/media\/7531"}],"wp:attachment":[{"href":"https:\/\/www.site.cidsr.md\/en\/wp-json\/wp\/v2\/media?parent=7530"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}