Simplified follow-up after early medical abortion: 12-month experience of a telephone call and self-performed low-sensitivity urine pregnancy test

Abstract A positive urine pregnancy test (UPT) with adnexal mass in ectopic pregnancy is not the ultimate diagnosis. The incidence of ectopic pregnancy is about 27 per 1000 pregnancies [1]. On average, about 6–16% will present to an emergency department with first-trimester bleeding and abdominal pain [2]. On presenting with these symptoms with the simultaneous presence of an adnexal mass and an empty uterus, a UPT is of paramount importance to determine whether the symptoms are pregnancy related or not. When the UPT is positive, an ectopic pregnancy is not the only diagnosis as the rare entity of non-gestational ovarian choriocarcinoma (NGOC) should be considered. Here we present two case reports of NGOC, which were initially diagnosed as ectopic pregnancy. The first case is a 16-year-old girl, with vaginal bleeding and an adnexal mass due to an ovarian choriocarcinoma, She underwent unilateral oophorectomy and received multiple courses of chemotherapy. She is disease free without evidence of recurrence or metastasis after 12 months of follow-up. The second patient is also 16 years old and presented with an acute abdomen. She was diagnosed as a ruptured luteal cyst and underwent partial oophorectomy. When the pathologist diagnosed a choriocarcinoma she received multiple courses of chemotherapy, but thereafter an advanced disease was diagnosed with evidence of distant metastasis.

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Can a multilevel pregnancy test (MLPT) be used for medical abortion follow-up among women at more than 63 days’ gestation? Evidence from prenatal hCG data

Contraception ◽

10.1016/j.contraception.2017.07.033 ◽

2017 ◽

Vol 96 (4) ◽

pp. 269

Author(s):

T Shochet ◽

K Lerma ◽

J Blum ◽

WR Sheldon ◽

PD Blumenthal ◽

...

Keyword(s):

Medical Abortion ◽

Pregnancy Test

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Use of an at-home multilevel pregnancy test and an automated call-in system to follow-up the outcome of medical abortion

International Journal of Gynecology & Obstetrics ◽

10.1002/ijgo.12679 ◽

2018 ◽

Vol 144 (1) ◽

pp. 97-102 ◽

Cited By ~ 3

Author(s):

Holly Anger ◽

Rasha Dabash ◽

Melanie Peña ◽

Dolores Coutiño ◽

Manuel Bousiéguez ◽

...

Keyword(s):

Medical Abortion ◽

Pregnancy Test ◽

At Home

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Self-assessment of success of early medical abortion using a self-performed urine pregnancy test

The European Journal of Contraception & Reproductive Health Care ◽

10.1080/13625187.2019.1618446 ◽

2019 ◽

Vol 24 (4) ◽

pp. 319-321

Author(s):

Sharon Cameron ◽

Sam Rowlands ◽

Kristina Gemzell-Danielsson

Keyword(s):

Medical Abortion ◽

Self Assessment ◽

Pregnancy Test ◽

Urine Pregnancy Test

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Comparison of two low-sensitivity urine pregnancy tests for confirming the success of early medical abortion

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2017-101868 ◽

2017 ◽

Vol 44 (1) ◽

pp. 54-57 ◽

Cited By ~ 7

Author(s):

Sarah Louise Millar ◽

Sharon Tracey Cameron

Keyword(s):

Retrospective Review ◽

False Positive ◽

Clinical Signs ◽

Signs And Symptoms ◽

Medical Abortion ◽

Ongoing Pregnancy ◽

Self Assessment ◽

Clinical Signs And Symptoms ◽

Low Sensitivity ◽

Urine Pregnancy Test

BackgroundWe introduced a single-window low-sensitivity urine pregnancy test (LSPT) to replace a double-window LSPT (both 1000 IU hCG) for self-assessment of the outcome of early medical abortion (EMA) (≤63 days gestation) 2 weeks later. We wished to compare assessment of outcomes of EMA with each LSPT.MethodsA retrospective review of the outcomes of EMA during 10 months' use of the double-window LSPT and the subsequent 10 months' use of the single-window LSPT to compare (i) detection of ongoing pregnancies and (ii) false-positive and invalid results with each LSPT.Results492 and 555 women self-assessed the outcome of their EMA with the double- and single-window LSPTs, respectively. Ongoing pregnancies were uncommon and occurred in 4/1047 women (0.4%). Two of these four women did not conduct a LSPT as they presented before the LSPT was due with scant bleeding or continuing pregnancy symptoms. False-positive LSPT results occurred in 6 (1.2%) and 19 (3.4%) double- and single-window LSPT tests, respectively (P=0.0244). Invalid results were reported in 18 (3.6%) and 6 (1.1%) of double- and single-window LSPT groups, respectively (P=0.01).ConclusionThe introduction of the single-window LSPT has not impacted on the detection of ongoing pregnancy or on contact with the service due to a positive or invalid LSPT. Services could consider use of either LSPT but should also place emphasis on informing women about the clinical signs and symptoms that suggest failed abortion.

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