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

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.