Medical; Abortion, Fetus Clinical Trial
Official title:
A Comparison of Remote Follow-up After Medical Abortion Using Telephone and Serum Pregnancy Testing With Standard In-person Follow-up
Background: Medical abortions in Canada are provided using a standard regimen of
methotrexate and misoprostol. After these medications are administered, patients are most
commonly checked for termination of the pregnancy with an ultrasound and physical
examination at an in-clinic follow-up appointment. These follow-up appointments can be
inconvenient, costly, and take away from patient privacy. Furthermore, it has been suggested
that these follow-up appointments may not be necessary for patients.
Objective: To determine whether remote follow-up, using telephone and blood testing is a
feasible, safe, and effective method of follow‐up after medical abortion, compared to
standard care that requires an in-clinic visit and ultrasound.
This study offers women the option of remote follow-up by telephone combined with serum
Beta-human chorionic gonadotropin (β-hCG) testing or standard in-clinic follow up. We will
determine women's preferences for follow up, and compare adherence to the follow-up
schedule, number of clinical contacts, and outcomes of the abortion. This study will be
performed at two clinics in Toronto, the Bay Centre for Birth Control (BCBC) and the Choice
in Health Clinic (CIHC).
Primary Hypothesis: Follow-up will be more successful with RFU, compared to SFU.
The protocol is altered for women who have an ultrasound that shows only a gestational sac (no yolk sac or fetal pole). Women in both follow-up groups will have β-hCG testing on the day of methotrexate injection and again in 8 days. If the level does not fall by 50% or they have concerning symptoms, they are asked to return to clinic for evaluation. If the β-hCG level falls by 50% or more, they will continue to be followed as per the protocol in their chosen group, but will be followed until their β-hCG becomes negative. ;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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