- Email: [email protected]
Updated prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in an urban public hospital termination clinic
Abstracts / Contraception 90 (2014) 298–351
P37 ONLINE AVAILABILITY OF MIFEPRISTONE AND MISOPROSTOL Owens L Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, MD, USA
Conclusions: The proportions of women testing positive for CT and NG remained extremely high in the younger population obtaining a firsttrimester surgical abortion. Active screening and treatment are occurring in our setting. Future research would entail follow-up and surveillance of reinfection. Abortion care is an important opportunity to educate women and potentially reduce rates of CT and NG and long-term negative sequelae.
Burke A
http://dx.doi.org/10.1016/j.contraception.2014.05.059
Objectives: Almost 90% of United States counties lack an abortion provider. Given federal and state restrictions on abortion funding, many women lack true access to abortion. Some turn to online sources to obtain and self-administer abortion medications. This study explores online availability of medical abortion. Methods: Google was used to search for “mifepristone,” “misoprostol” and “medical abortion.” The top 100 hits and relevant sites reached from the hits were condensed into 90 unique sites. We evaluated each site for availability and cost of mifepristone and misoprostol as well as medical advice and gestational age recommendations for use. Results: Thirty-six of the 90 sites advertised or sold pharmaceuticals; 16 sold misoprostol, 3 sold mifepristone, and 3 sold kits containing both, costing $45–$60. The rest advertised pharmaceuticals but did not sell mifepristone or misoprostol. Twenty-two of the 36 sites advertising pharmaceuticals warned against using misoprostol during pregnancy. Five recommended gestational age limits for medical abortion: less than 9 weeks for three sites and during the first trimester for the others. Six sites gave appropriate warnings regarding bleeding, infection or failure. One Web site featured a “pharmacist” touting the products as “100% safe and effective” while warning that the medications are “not safe for use at home.” Conclusions: Deterrents such as waiting periods, funding restrictions and lack of nearby providers represent prohibitive barriers to abortion. As a result, some women seek abortion outside of clinical settings, even in the United States. Our research shows that medication abortion is available online but accompanied by advice of varying quality.
P39
http://dx.doi.org/10.1016/j.contraception.2014.05.058
P38 UPDATED PREVALENCE OF CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE IN AN URBAN PUBLIC HOSPITAL TERMINATION CLINIC Park J Rush University Medical Center, Chicago, IL, USA
309
“ONE PROBLEM BECAME ANOTHER”: A MIXED-METHODS STUDY OF IDENTIFICATION OF AND CARE FOR PATIENTS SEEKING ABORTION AFTER SEXUAL ASSAULT Perry R University of Illinois at Chicago College of Medicine, Chicago, IL, USA Murphy M, Rankin K, Cowett A, Haider S, Harwood B Objectives: Sexual assault as an indication for abortion and the clinical practices surrounding it are not well studied. We aimed to describe how pregnancies resulting from sexual assault are identified during abortion care and to explore clinical responses, with a focus on funding and support service referral. We sought to identify supportive or problematic aspects of current practices. Methods: This study consisted of a national survey of abortion providers, in-depth interviews with women who terminated pregnancies resulting from sexual assault and in-depth interviews with key stakeholders (abortion providers, administrators, social workers, sexual assault survivor advocates). Following statistical and thematic analyses, we merged data from all sources and drew on ecologic theory to explore clinical care for women terminating pregnancies resulting from sexual assault. Results: We analyzed survey data from 279 providers. Half (50%) routinely screened for sexual assault as the cause of undesired pregnancy, and 20% had protocols for care provision. Barriers to sexual assault identification and support service referral were reported and qualitative themes from stakeholder interviews expanded on these barriers. Patients indicated that the decision to disclose sexual assault is multifactorial and often tied to funding. Both patients and stakeholders suggested that the need for support specific to sexual assault may not be temporally related to abortion. Conclusions: Abortion care settings should be supportive of sexual assault disclosure and provide meaningful referrals. We may increase uptake of support services and facilitate recovery from sexual assault by integrating patient viewpoints on the best timing and sources of support into clinical care.
Fier J, Roston A, Stempinski K, Zimmerman L, Patel A http://dx.doi.org/10.1016/j.contraception.2014.05.060 Objectives: To assess the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrheae (NG) among women undergoing first-trimester surgical pregnancy termination in a public, urban hospital termination clinic and compare rates with previously published data. Methods: A retrospective chart review was conducted among 4759 women who underwent a first-trimester surgical termination from May 2011 through April 2012. The prevalence rates were compared by χ 2 test with previously published data from January 2006 through June 2006 from the same publicly funded pregnancy termination clinic. Results: During the study period, 561 women tested positive for CT (11.8%) and 128 women tested positive for NG (2.7%). In 2006, of 1974 women, 225 tested positive for CT (11.4%) and 51 tested positive for (2.6%) NG. There was no statistical difference between the time periods (p=.6468 for CT, p=.805 for NG).
P40 MARKERS OF INFLAMMATION AFTER OSMOTIC DILATOR INSERTION PRIOR TO SECOND-TRIMESTER ABORTION Roncari D Tufts Medical Center, Boston, MA, USA Politch J, McClusky J, Borgatta L Objectives: To evaluate markers of inflammation in amniotic fluid after osmotic dilator use prior to second-trimester surgical abortion.
P37 ONLINE AVAILABILITY OF MIFEPRISTONE AND MISOPROSTOL Owens L Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, MD, USA
Conclusions: The proportions of women testing positive for CT and NG remained extremely high in the younger population obtaining a firsttrimester surgical abortion. Active screening and treatment are occurring in our setting. Future research would entail follow-up and surveillance of reinfection. Abortion care is an important opportunity to educate women and potentially reduce rates of CT and NG and long-term negative sequelae.
Burke A
http://dx.doi.org/10.1016/j.contraception.2014.05.059
Objectives: Almost 90% of United States counties lack an abortion provider. Given federal and state restrictions on abortion funding, many women lack true access to abortion. Some turn to online sources to obtain and self-administer abortion medications. This study explores online availability of medical abortion. Methods: Google was used to search for “mifepristone,” “misoprostol” and “medical abortion.” The top 100 hits and relevant sites reached from the hits were condensed into 90 unique sites. We evaluated each site for availability and cost of mifepristone and misoprostol as well as medical advice and gestational age recommendations for use. Results: Thirty-six of the 90 sites advertised or sold pharmaceuticals; 16 sold misoprostol, 3 sold mifepristone, and 3 sold kits containing both, costing $45–$60. The rest advertised pharmaceuticals but did not sell mifepristone or misoprostol. Twenty-two of the 36 sites advertising pharmaceuticals warned against using misoprostol during pregnancy. Five recommended gestational age limits for medical abortion: less than 9 weeks for three sites and during the first trimester for the others. Six sites gave appropriate warnings regarding bleeding, infection or failure. One Web site featured a “pharmacist” touting the products as “100% safe and effective” while warning that the medications are “not safe for use at home.” Conclusions: Deterrents such as waiting periods, funding restrictions and lack of nearby providers represent prohibitive barriers to abortion. As a result, some women seek abortion outside of clinical settings, even in the United States. Our research shows that medication abortion is available online but accompanied by advice of varying quality.
P39
http://dx.doi.org/10.1016/j.contraception.2014.05.058
P38 UPDATED PREVALENCE OF CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE IN AN URBAN PUBLIC HOSPITAL TERMINATION CLINIC Park J Rush University Medical Center, Chicago, IL, USA
309
“ONE PROBLEM BECAME ANOTHER”: A MIXED-METHODS STUDY OF IDENTIFICATION OF AND CARE FOR PATIENTS SEEKING ABORTION AFTER SEXUAL ASSAULT Perry R University of Illinois at Chicago College of Medicine, Chicago, IL, USA Murphy M, Rankin K, Cowett A, Haider S, Harwood B Objectives: Sexual assault as an indication for abortion and the clinical practices surrounding it are not well studied. We aimed to describe how pregnancies resulting from sexual assault are identified during abortion care and to explore clinical responses, with a focus on funding and support service referral. We sought to identify supportive or problematic aspects of current practices. Methods: This study consisted of a national survey of abortion providers, in-depth interviews with women who terminated pregnancies resulting from sexual assault and in-depth interviews with key stakeholders (abortion providers, administrators, social workers, sexual assault survivor advocates). Following statistical and thematic analyses, we merged data from all sources and drew on ecologic theory to explore clinical care for women terminating pregnancies resulting from sexual assault. Results: We analyzed survey data from 279 providers. Half (50%) routinely screened for sexual assault as the cause of undesired pregnancy, and 20% had protocols for care provision. Barriers to sexual assault identification and support service referral were reported and qualitative themes from stakeholder interviews expanded on these barriers. Patients indicated that the decision to disclose sexual assault is multifactorial and often tied to funding. Both patients and stakeholders suggested that the need for support specific to sexual assault may not be temporally related to abortion. Conclusions: Abortion care settings should be supportive of sexual assault disclosure and provide meaningful referrals. We may increase uptake of support services and facilitate recovery from sexual assault by integrating patient viewpoints on the best timing and sources of support into clinical care.
Fier J, Roston A, Stempinski K, Zimmerman L, Patel A http://dx.doi.org/10.1016/j.contraception.2014.05.060 Objectives: To assess the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrheae (NG) among women undergoing first-trimester surgical pregnancy termination in a public, urban hospital termination clinic and compare rates with previously published data. Methods: A retrospective chart review was conducted among 4759 women who underwent a first-trimester surgical termination from May 2011 through April 2012. The prevalence rates were compared by χ 2 test with previously published data from January 2006 through June 2006 from the same publicly funded pregnancy termination clinic. Results: During the study period, 561 women tested positive for CT (11.8%) and 128 women tested positive for NG (2.7%). In 2006, of 1974 women, 225 tested positive for CT (11.4%) and 51 tested positive for (2.6%) NG. There was no statistical difference between the time periods (p=.6468 for CT, p=.805 for NG).
P40 MARKERS OF INFLAMMATION AFTER OSMOTIC DILATOR INSERTION PRIOR TO SECOND-TRIMESTER ABORTION Roncari D Tufts Medical Center, Boston, MA, USA Politch J, McClusky J, Borgatta L Objectives: To evaluate markers of inflammation in amniotic fluid after osmotic dilator use prior to second-trimester surgical abortion.