No test medical abortion - a review of the evidence on selective use of preabortion testing.
Journal
Current opinion in obstetrics & gynecology
ISSN: 1473-656X
Titre abrégé: Curr Opin Obstet Gynecol
Pays: England
ID NLM: 9007264
Informations de publication
Date de publication:
08 Aug 2024
08 Aug 2024
Historique:
medline:
7
8
2024
pubmed:
7
8
2024
entrez:
7
8
2024
Statut:
aheadofprint
Résumé
The last decade has seen a cascade of different telemedicine models for medical abortion (MA) being tested and implemented. Among these service delivery models is the 'no-test' MA model, in which care is provided remotely and eligibility for the MA is based on history alone. The purpose of this review is to provide an overview of the existing evidence for no-test MA. The evidence base for no-test MA relies heavily on cohort and noncomparative studies predominantly from high resource settings. Recent findings indicate that no-test MA is safe, effective, and highly acceptable. Diagnoses of ectopic pregnancy and underestimation of gestational age were rare. Identified advantages included shortening time to access MA and mitigating access barriers such as cost, and geographical barriers. Abortion seekers valued omitting the ultrasound citing reasons such as privacy concerns, costs, more flexibility, and control. Due to lack of evidence, the impacts of no-test MA on unscheduled postabortion contacts and visits and on contraceptive use were unclear due to limited evidence. No-test MA can be provided to complement other care pathways including those with some or no in-person care. Further research is needed to allow for widespread adoption of no-test MA and scale-up in a variety of contexts, including low-resource settings.
Identifiants
pubmed: 39109610
doi: 10.1097/GCO.0000000000000981
pii: 00001703-990000000-00146
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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