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Abstract
Discussion Forum (0)
Introduction:
Remote follow-up protocols after medical abortion (MAB) are evidence-based, but telehealth follow-up after medical management of early pregnancy loss (EPL) has not been investigated. In this study, we compare feasibility of remote follow-up for EPL to remote follow-up for MAB.
Methods:
We conducted a retrospective cohort study of patients initiating medical management of EPL up to 12w6d and MAB up to 9w6d with mifepristone 200mg orally followed by misoprostol 800mcg vaginally between 4/1/2020 - 10/17/2020. Patients were routinely scheduled for telehealth follow-up in one week and home urine pregnancy test in 4 weeks. Our primary outcome was feasibility of telehealth follow-up for EPL compared with MAB patients, defined by successful follow-up per clinical protocol. Exploratory outcomes included comparative effectiveness and safety.
Results:
Ninety patients (40 EPL, 50 MAB) were eligible for inclusion. The median gestational age was 7w3d for patients with EPL and 7w0d for patients undergoing MAB. Of patients eligible for telehealth follow-up, 17/19 (89%) with EPL and 28/30 (93%) undergoing MAB successfully followed up per protocol (p=0.63). Telehealth assessments were consistent with completed abortion in 13/17 (76%) patients with EPL and 24/28 (86%) patients undergoing MAB (p=0.43). All (4/4) of EPL and 4/5 of MAB patients for whom a clinic visit was subsequently recommended completed this visit. Of these, 1/4 with EPL and 2/4 undergoing MAB required uterine aspiration. Among those with telehealth assessments consistent with completed abortion, neither group had documented complications within 30 days.
Conclusion/Implications:
Telehealth follow-up is a feasible alternative to in-person assessment after medical management of EPL.
Remote follow-up protocols after medical abortion (MAB) are evidence-based, but telehealth follow-up after medical management of early pregnancy loss (EPL) has not been investigated. In this study, we compare feasibility of remote follow-up for EPL to remote follow-up for MAB.
Methods:
We conducted a retrospective cohort study of patients initiating medical management of EPL up to 12w6d and MAB up to 9w6d with mifepristone 200mg orally followed by misoprostol 800mcg vaginally between 4/1/2020 - 10/17/2020. Patients were routinely scheduled for telehealth follow-up in one week and home urine pregnancy test in 4 weeks. Our primary outcome was feasibility of telehealth follow-up for EPL compared with MAB patients, defined by successful follow-up per clinical protocol. Exploratory outcomes included comparative effectiveness and safety.
Results:
Ninety patients (40 EPL, 50 MAB) were eligible for inclusion. The median gestational age was 7w3d for patients with EPL and 7w0d for patients undergoing MAB. Of patients eligible for telehealth follow-up, 17/19 (89%) with EPL and 28/30 (93%) undergoing MAB successfully followed up per protocol (p=0.63). Telehealth assessments were consistent with completed abortion in 13/17 (76%) patients with EPL and 24/28 (86%) patients undergoing MAB (p=0.43). All (4/4) of EPL and 4/5 of MAB patients for whom a clinic visit was subsequently recommended completed this visit. Of these, 1/4 with EPL and 2/4 undergoing MAB required uterine aspiration. Among those with telehealth assessments consistent with completed abortion, neither group had documented complications within 30 days.
Conclusion/Implications:
Telehealth follow-up is a feasible alternative to in-person assessment after medical management of EPL.
Introduction:
Remote follow-up protocols after medical abortion (MAB) are evidence-based, but telehealth follow-up after medical management of early pregnancy loss (EPL) has not been investigated. In this study, we compare feasibility of remote follow-up for EPL to remote follow-up for MAB.
Methods:
We conducted a retrospective cohort study of patients initiating medical management of EPL up to 12w6d and MAB up to 9w6d with mifepristone 200mg orally followed by misoprostol 800mcg vaginally between 4/1/2020 - 10/17/2020. Patients were routinely scheduled for telehealth follow-up in one week and home urine pregnancy test in 4 weeks. Our primary outcome was feasibility of telehealth follow-up for EPL compared with MAB patients, defined by successful follow-up per clinical protocol. Exploratory outcomes included comparative effectiveness and safety.
Results:
Ninety patients (40 EPL, 50 MAB) were eligible for inclusion. The median gestational age was 7w3d for patients with EPL and 7w0d for patients undergoing MAB. Of patients eligible for telehealth follow-up, 17/19 (89%) with EPL and 28/30 (93%) undergoing MAB successfully followed up per protocol (p=0.63). Telehealth assessments were consistent with completed abortion in 13/17 (76%) patients with EPL and 24/28 (86%) patients undergoing MAB (p=0.43). All (4/4) of EPL and 4/5 of MAB patients for whom a clinic visit was subsequently recommended completed this visit. Of these, 1/4 with EPL and 2/4 undergoing MAB required uterine aspiration. Among those with telehealth assessments consistent with completed abortion, neither group had documented complications within 30 days.
Conclusion/Implications:
Telehealth follow-up is a feasible alternative to in-person assessment after medical management of EPL.
Remote follow-up protocols after medical abortion (MAB) are evidence-based, but telehealth follow-up after medical management of early pregnancy loss (EPL) has not been investigated. In this study, we compare feasibility of remote follow-up for EPL to remote follow-up for MAB.
Methods:
We conducted a retrospective cohort study of patients initiating medical management of EPL up to 12w6d and MAB up to 9w6d with mifepristone 200mg orally followed by misoprostol 800mcg vaginally between 4/1/2020 - 10/17/2020. Patients were routinely scheduled for telehealth follow-up in one week and home urine pregnancy test in 4 weeks. Our primary outcome was feasibility of telehealth follow-up for EPL compared with MAB patients, defined by successful follow-up per clinical protocol. Exploratory outcomes included comparative effectiveness and safety.
Results:
Ninety patients (40 EPL, 50 MAB) were eligible for inclusion. The median gestational age was 7w3d for patients with EPL and 7w0d for patients undergoing MAB. Of patients eligible for telehealth follow-up, 17/19 (89%) with EPL and 28/30 (93%) undergoing MAB successfully followed up per protocol (p=0.63). Telehealth assessments were consistent with completed abortion in 13/17 (76%) patients with EPL and 24/28 (86%) patients undergoing MAB (p=0.43). All (4/4) of EPL and 4/5 of MAB patients for whom a clinic visit was subsequently recommended completed this visit. Of these, 1/4 with EPL and 2/4 undergoing MAB required uterine aspiration. Among those with telehealth assessments consistent with completed abortion, neither group had documented complications within 30 days.
Conclusion/Implications:
Telehealth follow-up is a feasible alternative to in-person assessment after medical management of EPL.
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