Acceptability of Mifepristone and Misoprostol and Patients’ Experience With the Early Pregnancy Assessment Clinic at a Community Hospital in Canada

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada Pub Date : 2025-01-23 DOI:10.1016/j.jogc.2025.102771

Salwa Farooqi MD, MSc , Elyse Lackie MD , Alice Pham MD , Lynne Zolis MD , Kalpana Sharma MD , Karthika Devarajan MD , Kirsten Smith MD , Alexandra Nevin-Lam MD , Sabrina Lee MD , Heather Tempest RN , Elad Mei-Dan MD , Modupe Tunde-Byass MBBS

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引用次数: 0

Abstract

Objectives

Early pregnancy loss (EPL) is a common complication of pregnancy. Research has demonstrated the efficacy of mifepristone pre-treatment followed by misoprostol for the induction of an EPL. North York General Hospital (NYGH) provides an all-in-one Early Pregnancy Assessment Clinic (EPAC) to streamline the care of women with an EPL.

Methods

We conducted a prospective single cohort qualitative survey to understand patients’ satisfaction with mifepristone and misoprostol and their experience with EPAC at NYGH. We recruited 191 patients with a confirmed EPL. They were given mifepristone and misoprostol. We administered the validated modified version of the Short Form-36 Health Survey Revised quality of life scales questionnaire to study the following outcomes: (1) acceptability of mifepristone and misoprostol: cramping, bleeding, duration of treatment, and recommendation to others; (2) effect on social activities; and (3) participants’ overall satisfaction with the EPAC at NYGH.

Results

We found that 96% of our participants responded completely to our questionnaire. For cramping, 24% reported definitely acceptable, whereas 8% definitely unacceptable. For bleeding, 26% reported definitely acceptable, whereas 4.8% definitely unacceptable. For duration of treatment, 27% reported definitely acceptable and 2.7% definitely unacceptable. Finally, for recommendation to others, 41% reported definitely acceptable and 2.1% definitely unacceptable. The rating for NYGH’s EPAC was high, with 68% of participants rating it as excellent.

Conclusions

We found that the acceptability of the medical management at our EPAC for an EPL is high with the mifepristone and misoprostol protocol. This study encourages this treatment and the establishment of similar centres.

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加拿大一家社区医院早期妊娠评估门诊患者对米非司酮和米索前列醇的可接受性

目的：早期妊娠丢失是妊娠的常见并发症。研究已经证明了米非司酮预处理后米索前列醇诱导早期妊娠丢失（EPL）的有效性。北约克综合医院（NYGH）提供了一个一体化的早期妊娠评估诊所（EPAC），以简化对患有EPL的妇女的护理。设计：我们进行了一项前瞻性单队列定性调查，以了解患者对米非司酮和米索前列醇的满意度以及他们在纽约医院使用EPAC的经历。方法：我们招募了191例确诊的EPL患者。给予米非司酮和米索前列醇。我们使用经过验证的修改版的SF-36R健康调查问卷来研究以下结果：(1)米非司酮和米索前列醇的可接受性：痉挛、出血、治疗持续时间和向他人推荐；(2)对社会活动的影响；(3)参与者对纽约医院EPAC的整体满意度。结果：我们发现96%的参与者完全回答了我们的问卷。对于抽筋，24%的人表示绝对可以接受，而8%的人表示绝对不能接受。对于出血，26%报告绝对可接受，4.8%报告绝对不可接受。在治疗期间，27%的人表示绝对可接受，2.7%的人表示绝对不可接受。最后，对于向他人推荐，41%的人表示绝对可以接受，2.1%的人表示绝对不能接受。纽约gh的EPAC评分很高，68%的参与者认为它很好。结论：我们发现我们EPAC对EPL的医疗管理接受度很高，米非司酮和米索前列醇方案。这项研究鼓励这种治疗和建立类似的中心。

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来源期刊

Journal of obstetrics and gynaecology Canada OBSTETRICS & GYNECOLOGY-

CiteScore

3.30

自引率

5.60%

发文量

302

审稿时长

32 days

期刊介绍： Journal of Obstetrics and Gynaecology Canada (JOGC) is Canada"s peer-reviewed journal of obstetrics, gynaecology, and women"s health. Each monthly issue contains original research articles, reviews, case reports, commentaries, and editorials on all aspects of reproductive health. JOGC is the original publication source of evidence-based clinical guidelines, committee opinions, and policy statements that derive from standing or ad hoc committees of the Society of Obstetricians and Gynaecologists of Canada. JOGC is included in the National Library of Medicine"s MEDLINE database, and abstracts from JOGC are accessible on PubMed.