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Assessing an abortion without ultrasound.

Nurses in low-resource settings can effectively determine the completeness of a medication abortion without using an ultrasound, according to a study of 718 women who received a medication abortion at five public hospitals in Maputo City, Mozambique, between May 2005 and December 2006. (1) On the basis of findings from the physical examination of patients 4-6 days and 12-21 days after administration of misoprostol, and of patients' reports of bleeding, pain and tissue passage, nurses trained to evaluate the completeness of a medication abortion determined that 83% of patients had had a complete abortion, 15% had had an incomplete abortion and 2% had an ongoing pregnancy. Gynecologists trained in abdominal ultrasound--and blinded to nurses assessments--evaluated the same women and determined that 80% had had a complete abortion, 17% had had an incomplete abortion and 3% had an ongoing pregnancy. Overall, nurses and gynecologists agreed in their diagnoses in 84% of cases. The authors comment that their findings "indicate the potential for successfully training midlevel providers to assess pregnancy expulsion following misoprostol abortions without the use of ultrasonography and thereby increasing the accessibility of safe, effective abortion services in decentralized health-care settings."

(1.) Gebresclassic H et at., Clinical diagnosis of completeness of medical abortion by nurses: a reliability study in Mozambique, Contraception, 2012, 86(1):74-78.

Update is compiled and written by Jared Rosenberg, senior editor of International Perspectives on Sexual and Reproductive Health.

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Title Annotation:UPDATE
Author:Rosenberg, Jared
Publication:International Perspectives on Sexual and Reproductive Health
Article Type:Brief article
Geographic Code:6MOZA
Date:Dec 1, 2012
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