Simplified medical abortion using a semi-quantitative pregnancy test for home-based follow-up

Objective: To simplify follow-up after medical abortion by examining whether women could use a semi- quantitative pregnancy test at home to screen for ongoing pregnancy. Methods: Three hundred women seek- ing medical abortion at a tertiary hospital in Vietnam participated in the study. Participants used a semi- quantitative pregnancy test at the hospital to estimate baseline human chorionic gonadotropin (hCG) levels and administered another test at home 2 weeks later for comparison. Women interpreted the test result at home and then returned to hospital for follow-up care. At this visit, self-assessment was verified. To assess further the feasibility of the test as a follow-up tool in service delivery, 200 additional women completed a user comprehension survey. Results: The tests identified all 11 ongoing pregnancies among study participants (100% sensitivity; 89.7% specificity). Women reported that the test was easy to use (255/292 [87.3%]) and that provider instructions helped them to use the test (291/292 [99.7%]). Conclusion: Semi-quantitative preg- nancy tests offer high sensitivity and negative predictive value. If user instructions can be further simplified, the tests could be used in lieu of transvaginal ultrasound and/or serum hCG at clinic-based follow-up or by women themselves for home-based follow-up.

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