Patient-controlled intravenous versus on-demand oral, intramuscular or mcs intravenous administration of oxycodone during medical induced abortion from 64 to 128 days of Gestation: A randomized controlled trial

Kemppainen, Venla; Mentula, Maarit; Palkama, Vilja J.; Heikinheimo, Oskari

doi:10.1016/j.contraception.2022.07.001

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…Reports of severe pain among women in our study are in line with the estimates of between half and three-quarters of such patients reporting moderate to high levels of pain. 37 , 38 , 39 , 40 , 41 The effectiveness of any pain-management strategy will depend in large part on how prepared patients are to anticipate requiring its use. The non-use of the offered analgesia by some women in our study is consistent with the findings of studies showing ineffective use of painkillers during home-managed medical abortion: nearly 25% used no analgesia at all.…”

Section: Discussionmentioning

confidence: 99%

How can patient experience of abortion care be improved? Evidence from the SACHA study

Lewandowska,

Scott,

Meiksin

et al. 2024

Womens Health (Lond Engl)

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Background: Models of abortion care have changed significantly in the last decade, most markedly during the COVID-19 pandemic, when home management of early medical abortion with telemedical support was approved in Britain. Objective: Our study aimed to examine women’s satisfaction with abortion care and their suggestions for improvements. Design: Qualitative, in-depth, semi-structured interviews. Methods: A purposive sample of 48 women with recent experience of abortion was recruited between July 2021 and August 2022 from independent sector and National Health Service abortion services in Scotland, Wales and England. Interviews were conducted by phone or via video call. Women were asked about their abortion experience and for suggestions for any improvements that could be made along their patient journey – from help-seeking, the initial consultation, referral, treatment, to aftercare. Data were analyzed using the Framework Method. Results: Participants were aged 16–43 years; 39 had had a medical abortion, 8 a surgical abortion, and 1 both. The majority were satisfied with their clinical care. The supportive, kind and non-judgmental attitudes of abortion providers were highly valued, as was the convenience afforded by remotely supported home management of medical abortion. Suggestions for improvement across the patient journey centred around the need for timely care; greater correspondence between expectations and reality; the importance of choice; and the need for greater personal and emotional support. Conclusion: Recent changes in models of care present both opportunities and challenges for quality of care. The perspectives of patients highlight further opportunities for improving care and support. The principles of timely care, choice, management of expectations, and emotional support should inform further service configuration.

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Section: Discussionmentioning

confidence: 99%

How can patient experience of abortion care be improved? Evidence from the SACHA study

Lewandowska,

Scott,

Meiksin

et al. 2024

Womens Health (Lond Engl)

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“…The most effective PCA regimen has been 50 micrograms fentanyl administered on demand with a 3 min lockout [14]. A recent trial compared PCA as intravenous oxycodone to oral, intravenous or intramuscular oxycodone given on demand [15 ▪▪ ]. Pain scores were high at median peak maximal pain on a VAS scale of 62 millimeters in the PCA group and 71 ( P = 0.52) in the control group.…”

Section: Pain Managementmentioning

confidence: 99%

Medical abortion in the second trimester – an update

Kopp Kallner

2023

Current Opinion in Obstetrics &Amp; Gynecology

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The safety and efficacy of medical abortion in the second trimester is provider independent and may therefore offer advantages over surgical second trimester abortion in certain settings. Due to bleeding risk, medical abortions in the second trimester are still mostly performed in a clinic or hospital setting. The most effective regimen for abortion includes pretreatment with oral mifepristone and following doses of misoprostol. An alternative is misoprostol only which should only be used when mifepristone is not available. The optimal dosing of prostaglandin to achieve the highest efficacy with the lowest proportion of complications remains to be established. Complications are rare and serious adverse events uncommon but may include uterine rupture especially in women with a previous cesarean delivery or uterine surgery. Women having second trimester medical abortion are a diverse group with different indications for the abortion. All women should be offered pain relief and respectful care. Staff involved in second trimester medical abortion often find their work challenging. At the same time, staff indicate pride and a conviction of contributing to the ‘greater good’ for women and society. Staff involved in second trimester abortion should be offered guidance and support through the employer. Post abortion contraception should be offered to all women having second trimester medical abortions, including those who have the abortion due to fetal malformation. All methods of contraception can be started immediately after a second trimester medical abortion except for cycle based methods and diaphragms.

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Patient-controlled intravenous versus on-demand oral, intramuscular or mcs intravenous administration of oxycodone during medical induced abortion from 64 to 128 days of Gestation: A randomized controlled trial

Cited by 2 publications

References 16 publications

How can patient experience of abortion care be improved? Evidence from the SACHA study

How can patient experience of abortion care be improved? Evidence from the SACHA study

Medical abortion in the second trimester – an update

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