Clinical outcomes from a prospective study evaluating the role of ambulation during medical termination of pregnancy

• Published in: Contraception (Stoneham) Vol. 85; no. 4; pp. 398 - 401
• Main Authors: Ojha, Kamal, Gillott, David J, Wood, Patricia, Valcarcel, Elizabeth, Matah, Arti, Talaulikar, Vikram S
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2012; Elsevier
• Subjects: Abortifacient Agents - therapeutic use; Abortion, Induced - methods; Adult; Ambulation; Biological and medical sciences; Birth control; Female; Genital system. Reproduction; Gynecology. Andrology. Obstetrics; Humans; Induced abortion. Therapeutic abortion; Medical abortion; Medical sciences; Mifepristone - therapeutic use; Misoprostol - therapeutic use; Obstetrics and Gynecology; Patient Preference; Pharmacology. Drug treatments; Pregnancy; Prospective Studies; Termination of pregnancy; Treatment Outcome; United Kingdom; Walking; Ambulation; Medical abortion; Termination of pregnancy; Prognosis; Induced abortion
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2011.08.008

Abstract Background Although induced abortion is one of the most commonly performed gynecological procedures in Great Britain and medical termination of pregnancy is being used more frequently, very little is known about the role of ambulation during the procedure. We sought to compare ambulatory and non-ambulatory groups of patients undergoing medical termination in the hospital setting and determine whether ambulation impacted clinical outcomes. Study Design This was a prospective patient-preference study carried out among 130 women with pregnancies up to 63 days of gestation fulfilling the requirements of the 1967 Abortion Act and undergoing medical termination of pregnancy. The objective was to evaluate the effect of ambulation during medical termination of pregnancy. The women were given the choice to be ambulatory or non-ambulatory throughout the process of medical termination of pregnancy. They received 200 mg oral mifepristone and 800 mcg vaginal misoprostol for the termination procedure. Outcomes measured included time taken to pass the products of conception, first feeling of abdominal cramps, estimated blood loss, time to discharge from the hospital, pain scores and need for analgesia. Results In both ambulatory and non-ambulatory groups, the mean time taken to pass the products of conception was similar: 230.7 min (118–343.4) and 233.0 min (134.5–331.5) for ambulatory and non-ambulatory patients, respectively. Time to onset of cramps was 75.6 min (29.4–121.8) for ambulatory and 91.7 min (22.2–161.2) for non-ambulatory patients, from administration of misoprostol. Mean estimated blood loss (assessed by weighing the pads as well as blood in bed pan) was less than 100 mL in both groups, and overall, approximately 85% of patients ranked their pain score as 3 or less (on a scale of 0–5). There were no statistically significant differences in the ambulatory versus non-ambulatory groups with regard to clinical outcomes. Conclusion Ambulation during medical termination of pregnancy neither appears to influence the amount of bleeding or pain nor hasten the process of medical termination of pregnancy.