title: Administration of depot medroxyprogesterone acetate on the day of mifepristone for medical abortion: a pilot study.
abstract: OBJECTIVE
  We sought to evaluate satisfaction with timing of administration and continuation rates of depot medroxyprogesterone (DMPA) when given on the initial visit for first-trimester medical abortion.
  
  
  METHODS
  In this pilot study, we administered DMPA within 15 min of mifepristone administration. Participants were followed up in the clinic 7 days after enrollment and were contacted at 14 days, 28 days and 3, 6, 9 and 12 months by telephone. We assessed satisfaction with contraception timing, DMPA continuation, bleeding patterns and abortion completion.
  
  
  RESULTS
  Twenty women were enrolled. At 7-day follow-up, 18 of 19 contacted participants (94.7%) were satisfied with timing of DMPA administration. Ten of 19 participants (52.6%) discontinued DMPA after the first injection. At 1 year, 3 participants out of 19 were continuing DMPA (15.7%). The median number of bleeding days after abortion was 19. Three participants had medical abortion failure. In the first year after abortion, there were four known repeat pregnancies.
  
  
  CONCLUSIONS
  The timing of initiation of DMPA on the initial visit for medical abortion is satisfactory to women, but its influence on medical abortion efficacy requires further study. Continuation rates for DMPA were low in our sample.
  
  
  CONCLUSIONS
  This pilot study provides groundwork for future larger studies to assess initiation of the injectable contraceptive DMPA on the day of mifepristone for medical abortion, but low continuation rates of DMPA in our sample emphasize the importance of access to intrauterine devices and implants after abortion.
authors.affiliation: Boston Medical Center, Department of Obstetrics and Gynecology. Electronic address: sonalkas@uphs.upenn.edu.
authors.forename: Sarita
authors.initials: S
authors.lastname: Sonalkar
authors.affiliation: Boston Medical Center, Department of Obstetrics and Gynecology.
authors.forename: Jessica
authors.initials: J
authors.lastname: McClusky
authors.affiliation: Boston Medical Center, Department of Obstetrics and Gynecology.
authors.forename: Melody Y
authors.initials: MY
authors.lastname: Hou
authors.affiliation: Boston Medical Center, Department of Obstetrics and Gynecology.
authors.forename: Lynn
authors.initials: L
authors.lastname: Borgatta
mesh_terms: D000021:Abortifacient Agents, Steroidal; D000027:Abortion, Incomplete; D000028:Abortion, Induced; D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D001900:Boston; D003268:Contraception Behavior; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000009:adverse effects; D015735:Mifepristone; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D019990:Perioperative Care; D010865:Pilot Projects; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D055815:Young Adult
chemical_list: D000021:Abortifacient Agents, Steroidal; D003271:Contraceptive Agents, Female; D004343:Drug Implants; D015735:Mifepristone; D017258:Medroxyprogesterone Acetate
keywords: Depot medroxyprogesterone acetate; First-trimester abortion; Long-acting reversible contraception; Medical abortion; Mifepristone