At-home urine pregnancy test assessment after mifepristone and misoprostol for undesired pregnancy of unknown location

Contraception. 2023 Apr:120:109955. doi: 10.1016/j.contraception.2023.109955. Epub 2023 Jan 9.

Abstract

Objectives: The ideal assessment after mifepristone and misoprostol for undesired pregnancy of unknown location (PUL) is unknown.

Study design: We prospectively followed patients at Planned Parenthood League of Massachusetts (2019-2021) with PUL who received immediate mifepristone and misoprostol with serial at-home urine pregnancy tests (UPT) and in-office serum HCGs.

Results: Of 13 patients, 10 had a successful medication abortion. For those who completed UPTs (N = 9), all were negative by Day 14. Two abnormal pregnancies had positive UPTs on Day 14.

Conclusion: A negative UPT on Day 14 may help determine complete abortion after medication abortion for undesired PUL. A positive UPT on Day 14 warrants further evaluation.

Implication: Patients taking mifepristone and misoprostol in the setting of undesired PUL who cannot access serum testing may consider an at-home UPT to confirm complete abortion.

Keywords: Follow-up; Medication abortion; Pregnancy of unknown location; Urine pregnancy test.

MeSH terms

  • Abortifacient Agents, Nonsteroidal*
  • Abortifacient Agents, Steroidal*
  • Abortion, Induced*
  • Abortion, Spontaneous*
  • Female
  • Humans
  • Mifepristone / therapeutic use
  • Misoprostol* / therapeutic use
  • Pregnancy
  • Pregnancy Tests*

Substances

  • Mifepristone
  • Misoprostol
  • Abortifacient Agents, Nonsteroidal
  • Abortifacient Agents, Steroidal