title: Medical abortion follow-up with serum human chorionic gonadotropin compared with ultrasonography: a randomized controlled trial.
abstract: OBJECTIVE
  To estimate whether follow-up with serum human chorionic gonadotropin (hCG) results in fewer unplanned visits and interventions than follow-up with ultrasonography.
  
  
  METHODS
  Women were randomized to either in-clinic serum hCG or ultrasound follow-up after medical abortion. The primary outcome, unplanned interventions and visits, was measured as a composite binary outcome including: additional clinic or emergency room visits, repeat dosing of misoprostol, and surgical evacuation of the uterus. Surveys were administered at initial follow-up and again 1 month after abortion to inquire about unscheduled visits, interventions, and patient satisfaction. Medical records were reviewed for evidence of additional interventions and visits.
  
  
  RESULTS
  A total of 376 patients was randomized. Most participants were white (56%), single (83%), nulliparous (63%), and had completed high school (96%). Average participant age was 26±6 years and average gestational age was 46±6 days. Within 2 weeks of abortion, there was no significant difference in the rate of unplanned interventions and visits between arms, 8.2% (13/159) in the serum hCG arm compared with 6.6% (10/151) in the ultrasound arm (relative risk 1.23, 95% confidence interval [CI] 0.56-2.73, P=.60). By 4 weeks postabortion, 4.4% (6/135) in the ultrasound arm and 1.4% (2/142) in the hCG arm had undergone surgical evacuation (relative risk 0.32, 95% CI 0.07-1.54, P=.16). The majority in both the serum hCG (88%) and ultrasound (95%) arms was satisfied with their assigned follow-up method.
  
  
  CONCLUSIONS
  Medical abortion follow-up with serum hCG does not reduce the rate of unplanned interventions and visits compared with ultrasonography. Overall, the number of unplanned interventions is low and both methods of follow-up are acceptable to women.
authors: Brigham and Women's Hospital and the Planned Parenthood League of Massachusetts, Boston, Massachusetts; and Planned Parenthood of New York City, New York, New York.
authors: Ila
authors: I
authors: Dayananda
authors: Rie
authors: R
authors: Maurer
authors: Jennifer
authors: J
authors: Fortin
authors: Alisa B
authors: AB
authors: Goldberg
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data*; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D011247:Pregnancy; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin
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