“False positive” urine pregnancy test results after successful medication abortion

Raymond, Elizabeth G.; Anger, H; Chong, Erica; Haskell, Sue; Grant, Melissa; Boraas, Christy M.; Tocce, Kristina; Banks, Joey; Kaneshiro, Bliss; Baldwin, Maureen K.; Coplon, Leah; Bednarek, Paula H.; Shochet, Tara; Platais, Ingrida

doi:10.1016/j.contraception.2021.02.004

Cited by 7 publications

(8 citation statements)

References 18 publications

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“…Follow-up usually includes a telemedicine encounter and a home urine pregnancy test 4 weeks after taking misoprostol with additional follow-up as needed. 14–17 , 27–29 , 31 …”

Section: Discussionmentioning

confidence: 99%

Telemedicine for First-Trimester Medical Abortion in Canada: Results of a 2019 Survey

Renner

Ennis

Kyeremeh

et al. 2023

Telemedicine and e-Health

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Introduction: Telemedicine has the potential to improve abortion access disparities in Canada. We aimed to explore the provision of telemedicine for first-trimester medical abortion and related barriers in 2019. Methods: We conducted a national, cross-sectional, anonymized, web-based survey of clinicians who provided abortion care in 2019 in Canada. We distributed our survey through professional health organizations to maximize identification of possible eligible respondents and used a modified Dillman technique to foster responses. Questions elicited provider demographics, clinical characteristics, including telemedicine first-trimester medical abortion and perceived related barriers. Descriptive statistics were analyzed using R software. Results: Among 465 respondents, 388 reported providing first-trimester medical abortion across Canada; 44.0% reported experience using telemedicine for some components of care: 49.3% of primary care clinicians and 28.7% of specialists. Telemedicine was used for initial consultation (86.0%), prescription (82.2%), or follow-up (92.2%). The median percentage of telemedicine providers' patients who underwent a dating ultrasound was 90.0. The majority usually followed up with patients through quantitative human chorionic gonadotropin (hCG) (84.2%). Seventy-eight percent perceived barriers to telemedicine; the most common being inability to confirm gestational age with ultrasound (43.0%), and lack of provincial telemedicine abortion fee code to pay practitioners (30.2%), timely access to serum hCG testing (24.6%), and nearby emergency services (23.3%). Discussion: In 2019, fewer than half of respondents reported providing some aspects of first-trimester medical abortion through telemedicine and the majority perceived barriers. Our results can inform knowledge translation activities to reduce barriers and increase telemedicine abortion care in Canada.

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“…Follow-up usually includes a telemedicine encounter and a home urine pregnancy test 4 weeks after taking misoprostol with additional follow-up as needed. 14–17 , 27–29 , 31 …”

Section: Discussionmentioning

confidence: 99%

Telemedicine for First-Trimester Medical Abortion in Canada: Results of a 2019 Survey

Renner

Ennis

Kyeremeh

et al. 2023

Telemedicine and e-Health

View full text Add to dashboard Cite

show abstract

“…48 When performed 4 weeks after mifepristone ingestion, a high-sensitive urine pregnancy test, which detects serum hCG levels of 25 milli-international units per milliliter of blood, or mIU/mL or more, can be positive in ~20% of people with a completed medication abortion. 49 Patients can be counseled that a pregnancy test done 5 weeks after medication abortion should be negative. If a patient who underwent SMA presents for care with a positive pregnancy test after this timeframe, clinicians should assess for continuing pregnancy and offer options within the scope of their practice and legal environment.…”

Section: Harm Reduction Approachmentioning

confidence: 99%

Self-managed Medication Abortion in the United States

Jung,

Nippita

2023

Clinical Obstetrics &Amp; Gynecology

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Self-managed abortion (SMA) is ending a pregnancy without medical supervision, either by obtaining medications (known as self-managed medication abortion) or through other means. Many factors influence a person’s decision to pursue self-managed abortion, such as time constraints, financial considerations, and local availability of abortion services. We present on the prevalence, methods and best practices for clinicians in the United States who may interface with individuals undergoing self-managed medication abortion at any point in the process through a harm reduction approach.

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“…In a study assessing the safety and feasibility of telemedicine medication abortion with pills directly mailed to clients, researchers utilized a HSPT for remote follow-up [17 ▪▪ ]. At a median of 30 days post mifepristone, the initial HSPT was negative in 81% of participants ( n = 384) and positive in the remaining 19%.…”

Section: High-sensitivity Urine Pregnancy Testmentioning

confidence: 99%

Update on medication abortion follow-up options: many sizes to fit all

Flynn

Lerma

2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewTo assess the efficacy, benefits, and limitations of available and emerging follow-up options for medication abortion.Recent findingsMedication abortion follow-up does not have to be a ‘one size fits all’ protocol. From most to least invasive, follow-up options include facility-based ultrasound, laboratory-based repeat serum beta-human chorionic gonadotropin (hCG) testing, urine hCG testing (high sensitivity, low sensitivity, and multilevel pregnancy tests), self-assessment with symptom evaluation, and no intervention. Provider or facility-dependent follow-up, including ultrasound and serum testing are effective, but have several limitations, including needing to return to a facility and cost. Remote, client-led follow-up options, such as urine pregnancy testing and symptoms evaluation, are well tolerated and effective for ruling out the rare outcome of ongoing pregnancy after medication abortion and have several advantages. Advantages include being inexpensive and flexible. However, it is important to note that low-sensitivity and multilevel pregnancy tests are not available in all settings. In studies evaluating client-led follow-up with urine pregnancy tests, ongoing pregnancies were identified over half the time with symptoms alone.SummaryGuidelines from several professional organizations have aligned with the evidence and no longer recommend routine office-based follow-up. To ensure care is person-centered, providers should offer follow-up options that align with the comfort, logistical ability, and values of the client.

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“False positive” urine pregnancy test results after successful medication abortion

Cited by 7 publications

References 18 publications

Telemedicine for First-Trimester Medical Abortion in Canada: Results of a 2019 Survey

Telemedicine for First-Trimester Medical Abortion in Canada: Results of a 2019 Survey

Self-managed Medication Abortion in the United States

Update on medication abortion follow-up options: many sizes to fit all

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