Objective: To investigate if a self-administered semi-quantitative urine pregnancy test (SQ-UPT) can reduce the number of in-person visits required to confirm complete abortion after very early surgical abortion.
Study design: Women seeking abortion at 6 weeks or less were randomized to follow-up by either: initial serum human chorionic gonadotropin (hCG) and serum hCG one week later, or initial SQ-UPT and subsequent home SQ-UPT one week later. The primary outcome was the percentage of women in each group with a complete abortion who required any in-person visit for serum hCG, ultrasound or examination to confirm completion. Secondary outcomes included, patient adherence and satisfaction with assigned follow-up and physician’s confidence in identifying the gestational sac in the uterine aspirate.
Results: Fifty-one patients were randomized. To confirm completed abortion, 100% of women in the serum hCG arm required an additional visit for a subsequent serum hCG compared to 3 (12.5%) women in the SQ-UPT arm (p <0.0001). The one ongoing pregnancy in the SQ-UPT arm was detected by the test. Significantly more women were adherent with at-home follow-up: 70.6% of the serum hCG group returned for repeat serum testing whereas 100% of the SQ-UPT arm completed home testing and phone follow-up. Conclusion: The SQ-UPT may be an effective and acceptable method to confirm completion of a very early surgical abortion. Implications: After very early surgical abortion, when ectopic pregnancy is excluded but a gestational sac cannot be identified with confidence in the uterine aspirate,the semi-quantitative urine pregnancy test may be a preferred method of follow-up and may improve access to very early abortion.