Obstetrics & Gynecology · 3 h ago
Self-assessment improved follow-up after early medical abortion in New Zealand trial
In a multicentre randomised trial of 732 women having early medical abortion in New Zealand, self-assessment with a low-sensitivity urine pregnancy test was compared with blood-test follow-up. Complete follow-up was more common with self-assessment, while complications and several other outcomes showed no significant differences.
- Randomised trial included 732 participants at six New Zealand services.
- Complete follow-up was 94.5% with self-assessment versus 67.4%.
- Complication rates were similar between groups.
- One ongoing pregnancy was detected after the first trimester.
The Mate Whenua multicentre, parallel-group randomised controlled trial enrolled 732 women having early medical abortion at six abortion services in Aotearoa New Zealand. Participants were assigned to follow-up using self-assessment with a low-sensitivity urine pregnancy test or comparative serum beta-hCG testing. The primary outcome was complete follow-up, defined as being able to discuss the test result within six weeks.
Complete follow-up was recorded for 94.5% of participants in the self-assessment group and 67.4% in the blood-test group (relative risk 1.41, 95% CI 1.30–1.52; p<0.001). Successful abortion was also more common with self-assessment (89.0% vs 81.0%; RR 1.10, 95% CI 1.03–1.17), as were additional follow-up investigations (17.3% vs 11.1%). The groups had no reported differences in contraception, additional healthcare visits, community prescriptions or complications. One ongoing live pregnancy was detected after the first trimester.
The authors recommend self-assessment after early medical abortion. The results support this approach in the participating services, but the abstract provides limited detail on outcome definitions and follow-up procedures; the finding of one ongoing pregnancy also underscores the importance of reliable follow-up. Applicability beyond the New Zealand services studied is uncertain.
In practice
For services providing early medical abortion, this trial supports considering self-assessment with a low-sensitivity urine pregnancy test as a follow-up option: among 732 participants at six New Zealand services, complete follow-up within six weeks was more frequent than with comparative serum beta-hCG testing. Complication rates did not differ in the reported results, but one ongoing live pregnancy was detected after the first trimester. The findings do not establish applicability in settings with different follow-up systems or populations.
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BJOG: An International Journal of Obstetrics & Gynaecology: Mate Whenua—Follow‐Up After Early Medical Abortion in New Zealand: A Randomised Controlled Trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.