Objective: To compare demographics and clinical outcomes between patients who had no investigations with those who had investigations prior to receiving a prescription for medication abortion (MA) during the first 6 months of the COVID-19 pandemic. Outcomes include success rates, adverse events, pathways to completion, and loss to follow-up rates.
Methods: We conducted a retrospective chart review of 1452 patients presenting for MA between 23 March 2020 and 30 September 2020. Descriptive statistics, 2×2 Chi-square tests, and Fisher's exact tests were used to compare characteristics and outcomes between groups.
Results: Of the 1307 patients who received a prescription, 895 (68.5%) were in the no-test group and 412 (31.5%) were in the test group. Success rate was 95.2% with no significant difference between groups (94.0%, 95.8%, P = 0.194). Rates of adverse events were low with 28 patients presenting for emergency room visits (2.1%), 62 having clinically significant retained products of conception (4.7%), 5 with heavy bleeding requiring treatment (0.4%), 16 with ongoing pregnancy (1.2%), and 3 requiring ectopic management (0.2%). Completion of abortion was verified in 1034 patients (80.5%) and loss to follow-rate was 22.6% with no difference between the groups (82.1% vs. 79.8%, P = 0.341 and 21.4% vs. 23.1%, P = 0.477, respectively).
Conclusion: We found that clinical outcomes were consistent between both groups with high success rates and low adverse event rates. Our study contributes to the growing body of evidence that allows for individualized care implementing selective use of low- and no-test MA protocols.
Keywords: Covid-19; Induced Abortion; Mifepristone; Misoprostol; Telemedicine; Ultrasound.
Copyright © 2024. Published by Elsevier Inc.