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Master Thesis

Can women accurately assess the outcome of medical abortion based on self-assessment and low sensitivity urine pregnancy test ?

Abstract : Background: Failed medical terminations of pregnancy (MToP) can have serious consequences such as exceeding the legal age of abortion and the occurrence of fetal malformations related to the teratogenic action of misoprostol. Objective: To study the correlation between a low-sensitivity urine pregnancy (LSUP) test associated to a self-performed questionnaire and the standard patient follow-up after an MToP, consisting of a clinical examination, a blood test for hCG and ultrasonography when needed. Methods: Prospective cohort study including women who came to their post-abortion visit after an MToP from April to September 2017. They performed an LSUP test and a self-performed questionnaire to assess their opinion on the completion of the abortion. Then a standard follow-up was done by a doctor. A successful MToP was defined as a complete uterine abortion, with no need for surgical intervention or for new abortive medication. Results: 133 women were included in this study. The rate of successful MToP was 94.0%. Regarding failures, there were two ongoing pregnancies (1.5%) and six retained products of conception (4.5%) treated either by a surgical procedure or with a renewed oral administration of misoprostol. Sensitivity of the LSUP test associated with the women’s opinion was 100%, specificity was 89.6%, positive predictive value 38.1%, negative predictive value 100%, with a Youden index of 0.89 and a kappa coefficient of 0.51. Conclusion: Given the extremely high efficacy of MToP, most women do not need a clinical follow-up to confirm pregnancy termination. Our data show that most women can ascertain their abortion outcome using a simple self-administrated questionnaire associated with a LSUP test.
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https://dumas.ccsd.cnrs.fr/dumas-01781729
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Submitted on : Thursday, June 7, 2018 - 12:25:48 PM
Last modification on : Thursday, July 9, 2020 - 12:30:44 PM

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Céline Pimentel. Can women accurately assess the outcome of medical abortion based on self-assessment and low sensitivity urine pregnancy test ?. Life Sciences [q-bio]. 2017. ⟨dumas-01781729⟩

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