Reducing the Need for In-Clinic Follow-Up for Medical Abortion in Moldova and Uzbekistan
The purpose of this study is to determine whether an alternative method of follow-up after medical abortion is acceptable and feasible for use in Moldova and Uzbekistan.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||The Acceptability and Feasibility of Reducing the Need for In-Clinic Follow-Up for First Trimester Medical Abortion in Moldova and Uzbekistan|
- Continued, ongoing pregnancy [ Time Frame: 1 month ] [ Designated as safety issue: No ]
- Percentage of women who return for follow-up [ Time Frame: 1 month ] [ Designated as safety issue: No ]
- Percentage of women receiving other treatment for ongoing pregnancy [ Time Frame: 1 month ] [ Designated as safety issue: No ]
|Study Start Date:||September 2010|
|Study Completion Date:||October 2012|
|Primary Completion Date:||October 2012 (Final data collection date for primary outcome measure)|
No Intervention: Standard of care
Standard of care includes a routine clinic visit two weeks after misoprostol administration. At the clinic visit, the woman undergoes a bimanual examination. In the event the woman fails to return for the follow-up visit, clinic procedure is followed for contacting her to determine abortion status and the need for further intervention, if any.
Active Comparator: Alternative follow-up
At a clinic visit, before mifepristone administration, the woman completes a semi-quantitative pregnancy test. After mifepristone administration, she is provided with another pregnancy test and a checklist to be self-administered two weeks after she takes misoprostol. On an assigned date, the woman is contacted by phone by the clinic staff and asked to report on the results of both tests. The provider then confirms whether, based on the woman's responses, she should return for a follow-up visit.
Other: Alternative follow-up
Alternative follow-up consists of a self-administered semi-quantitative pregnancy test designed to measure urine beta-hCG levels, and a self-administered questionnaire consisting of 7 questions. Results of both are reviewed by the provider to determine if in-clinic follow-up is needed.
Medical abortion using mifepristone and misoprostol is a highly effective procedure, but access to it may be impeded by the fact that not all women can afford or want to return for a follow-up visit. This often results in a high loss to follow-up rate. Additionally, with medical abortions of those women who do return for follow-up, higher costs are borne by both the woman and the healthcare system.
This study compares two methods of follow-up after medical abortion: standard of care versus alternative follow-up. The former involves a routine clinic visit two weeks after misoprostol administration. The latter consists of a low-sensitivity pregnancy test and a self-administered questionnaire. Based on the results of the test and questionnaire, women may be flagged as needing in-clinic follow-up or discharged from the study if their abortion is complete.
|Moldova, Republic of|
|The Perinatalogy Center|
|Balti, Moldova, Republic of|
|Municipal Clinical Hospital|
|Chisinau, Moldova, Republic of|
|The National Center of Reproductive Health and Medical Genetics|
|Chisinau, Moldova, Republic of|
|The Center of Women Health "Ana"|
|Drochia, Moldova, Republic of|
|Clinic #2 of Tashkent Medical Academy|
|Municipal Maternity House #10|
|Women's Wellness Center|
|Principal Investigator:||Hillary J. Bracken, PhD, MHS, MA||Gynuity Health Projects|
|Principal Investigator:||Beverly Winikoff, MD, MPH||Gynuity Health Projects|