Clinical outcomes from a prospective study evaluating the role of ambulation during medical termination of pregnancy.
BACKGROUND
Although induced abortion is one of the most commonly performed gynecological procedures in Great Britain and medical termination of pregnancy is being used more frequently, very little is known about the role of ambulation during the procedure. We sought to compare ambulatory and non-ambulatory groups of patients undergoing medical termination in the hospital setting and determine whether ambulation impacted clinical outcomes.


METHODS
This was a prospective patient-preference study carried out among 130 women with pregnancies up to 63 days of gestation fulfilling the requirements of the 1967 Abortion Act and undergoing medical termination of pregnancy. The objective was to evaluate the effect of ambulation during medical termination of pregnancy. The women were given the choice to be ambulatory or non-ambulatory throughout the process of medical termination of pregnancy. They received 200 mg oral mifepristone and 800 mcg vaginal misoprostol for the termination procedure. Outcomes measured included time taken to pass the products of conception, first feeling of abdominal cramps, estimated blood loss, time to discharge from the hospital, pain scores and need for analgesia.


RESULTS
In both ambulatory and non-ambulatory groups, the mean time taken to pass the products of conception was similar: 230.7 min (118-343.4) and 233.0 min (134.5-331.5) for ambulatory and non-ambulatory patients, respectively. Time to onset of cramps was 75.6 min (29.4-121.8) for ambulatory and 91.7 min (22.2-161.2) for non-ambulatory patients, from administration of misoprostol. Mean estimated blood loss (assessed by weighing the pads as well as blood in bed pan) was less than 100 mL in both groups, and overall, approximately 85% of patients ranked their pain score as 3 or less (on a scale of 0-5). There were no statistically significant differences in the ambulatory versus non-ambulatory groups with regard to clinical outcomes.


CONCLUSIONS
Ambulation during medical termination of pregnancy neither appears to influence the amount of bleeding or pain nor hasten the process of medical termination of pregnancy.
Department of Obstetrics and Gynaecology, St. George's Hospital and NHS Trust, Tooting, SW17 0QT, London, UK. Kamal.Ojha@stgeorges.nhs.uk
Kamal
K
Ojha
David J
DJ
Gillott
Patricia
P
Wood
Elizabeth
E
Valcarcel
Arti
A
Matah
Vikram S
VS
Talaulikar
D000019:Abortifacient Agents / Q000627:therapeutic use*; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D015735:Mifepristone / Q000627:therapeutic use*; D016595:Misoprostol / Q000627:therapeutic use*; D057240:Patient Preference; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D006113:United Kingdom; D016138:Walking
D000019:Abortifacient Agents; D016595:Misoprostol; D015735:Mifepristone