Effectiveness and acceptability of "at home" versus "at hospital" early medical abortion - A lesson from the COVID-19 pandemic: A retrospective cohort study

Posted: 2021-11-13 20:00:00
Background: Since the lockdown caused by the COVID-19 pandemic, restrictions on hospitals' activity forced healthcare practitioners to innovate in order to provide continuity of care to patients. The aim of this study was to evaluate the efficiency of a newly established protocol for medical abortion and to measure the level of satisfaction of the patients who experienced abortion at home. Methods: This retrospective study compared all the patients who had an early medical abortion at up to 9 weeks of gestation during the two drastically different periods between December 2018 and March 2021 ("hospital" and "home" groups). We evaluated the expulsion of the gestational sac as a primary outcome. The rates of infection, hemorrhage, retained trophoblastic material and need for surgical management were also assessed. A survey was also used to measure the satisfaction and acceptability of the method. Results: The rate of expulsion of pregnancy was not significantly different between the two groups: 92.9% in hospital versus 99% at home. Early retained trophoblastic material and surgical interventions were higher in the hospital group. No significant difference was observed for the remaining outcomes. Moreover, the level of acceptability was similar in both groups, though patients felt safer in the "hospital" group. Conclusion: Switching an early medical abortion protocol from expulsion of pregnancy in hospital to expulsion of pregnancy at home is effective and acceptable to women, and may be associated with decreased rate of retained trophoblastic material. Further larger studies are needed to test the long-term result of this protocol. Keywords: COVID-19; Home protocol; Hospital protocol; Medical abortion; SARS-CoV-2; Telemedicine.

参考サイト PubMed: covid-19

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12月 21, 2020 バイオアソシエイツ


脂肪組織が COVID-19 の悪化に重要な役割を果たすという証拠が増えている。 調査中の理論の1つは、脂肪細胞(adipocytes)がSARS-CoV-2の貯蔵庫として機能し、肥満または太りすぎの人のウイルス量を増加させるというものだ。科学者らはまた、感染中に脂肪細胞が血流中に放出され、生体内のウイルスによって引き起こされる炎症反応を促進すると考えている。これらの仮説は、ブラジルのサンパウロ大学医学部(FM-USP)臨床外科の教授 Marilia Cerqueira Leite…

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