FIGO 2015 980-P chosen contraception chosen failureor abortion medical not parity, HIVstatus patient’s gestational age, age, variables Demographic • • • reviewed charts 89 In our In our study, the success rate of medical abortion when a progestin day may be an acceptable option an be may day Astreamlined one administered on the same day as mifepristone was high (98%) etonogestrel • immediate placement of a progestin Objective • • • • bleeding and side effectalso necessary side bleeding and pregnancy are next to profiles, time and Acceptability and satisfaction studies to determine continuation of the chosen contraceptive, progestin Larger prospective studies are needed to assess success rates with concurrent placement of 1/3 HIVpositive With HIV over known status, Mean gestational d 53 = age Mean age of women = 25 25 = ofwomen Mean age anti etonogestrel complete abortion Historically,offeredfollow contraception at second injection at the same time as medical abortion etonogestrel Theoretical risk Theoretical (5) abortionlow rates repeat and (4) continuationhigh rates Studies when support contraception is given at time of abortion, contraception (3) family planning on focus New Major cause of maternalmortality in South Africa = unsafe abortion statistically relatedto - progestin effects of mifepristone, resulting an incomplete in abortion INTRODUCTION AND OBJECTIVES AND INTRODUCTION - based contraceptives - determine the success rate of medical abortion when followed by when followed medical abortion of therate success determine Jeanna Park Jeanna Termination of pregnancy implant or DMPA injection on the same day as mifepristone or DMPA)or medical at timeof interfere abortion may with medroxyprogesterone(DMPA)depot acetate or implant - – visit approach for medical abortion and contraceptive placement on the same the contraceptiveon and placement abortion medical visit for approach - 2 - progestin a providing Jeanna Department of ObstetricsandGynecology,Department Lower – but many many follow but women lost to - yrs Park, MD FUTURE DIRECTIONS ON THE SAMEDAY AS MEDICAL ABORTION RESULTS – CONCLUSIONS - providing immediate contraception with HIV%) status (n, %) (n, Gestational indays age %) (n, Parity (mean Age based contraceptive with the PROGESTIN Missing Positive Negative Missing days 57-63 days 50-56 days ≤49 Missing 3 ormore 2 1 0 1 Table 1: variablesDemographic Department of ObstetricsandGynecology,Department UniversityofIllinois,Chicago,USA 1 , Nuriya basedcontraceptive (i.e. ± SD) Robinson, MD Robinson, - - up visit after medical medical after up visit up and never receive receive never up and -BASED CONTRACEPTIVE 1 , - basedcontraceptive was Ursula 24.8 24.8 12 (14%) 12 (30%) 27 (56%) 50 (25%) 22 (37%) 33 (35%) 31 (17%) 15 (38%) 34 (25%) 22 11 (12%) subjects (n=89) Umfolozi 3 (3%) 7 (8%) All ± 5.3 10.3252/pso.eu.XXIFIGO.2015 Wessels District WarHospital, Memorial Total Contraception at • • • • 2 (2%) required surgical evacuation for an incomplete abortion 95 CI 95% (98%, 87 , MD Depot Etonogestrel Table 2: Medical abortion completion and chosen contraceptive DMPA contraception for days gestation 28 gestation 62 days and HIV negative women 1 Gravida • statistically significant relationship between variables and outcome statisticallyvariablesand significantrelationship between t- samples Independent conception of products of passage abortioncomplete completion = Medical • Inclusion criteria: Umfolozi in review Retrospective chart • • • • 2 Returned toReturned clinic or reached by phone for follow mifepristone as same day contraceptionthe on Pregnant women aged 15 aged women Pregnant Received either the either Received later hours 24 misoprostolby sublingual 800mcg followed 200mg oral mifepristone protocol with medical abortion Followed 2014 July and 2013 August between abortion medical Underwent Gestational age ≤ 63days by ultrasound , James Turner,James , MD medroxyprogesterone acetate District War Memorial Hospital and Eshowe Hospital. Eshowe District War and Hospital Memorial presented Poster not requiring not surgicalevacuation implant time of abortion time of - 100%) = complete abortion = complete abortion 100%) at: 1. 5. 2. 4. 3. etonogestrel tests and chi tests and http://www.kznhealth.gov.za/mcwh/Maternal/Saving Health. of Department Africa: South Africa. South in Deaths Maternal into Enquiries 2011 Mothers Saving undergoing immediate 2013 on returnon repeat for abortion. J Am Rose SB, Lawton BA.Impact oflong Nov;120(5):1053 Peipert http://www.hrw.org/world Watch. WorldRights Human 2011: Report Africa. South Madden, Madden, T., Eisenberg, D. L., Zhao, Q., study. pilot a 2013;88(5):671 Contraception. abortion: medical for mifepristone of day the on contraceptive implant Sonalkar 2011.africa. Published Accessed April 20, 2015. Empangeni 2 , FUNDING SOURCE: UNIVERSITYSOURCE: FUNDING OF ILLINOIS - Stacie short GLOBALHEALTH WOMEN’S FELLOWSHIP , J. F., J. Continuation of the METHODS - 49 S, KwaZulu - report.pdf. Published 2015. Accessed April 20, 2015. 20, report.pdf. Accessed 2015. April Published Hou Geller MY, - , South Africa , 9 - implant or DMPAor implant injection for REFERENCES squared tests to calculate to squared tests - Borgatta 2013: Sixth Report on the Confidential Confidential the on 2013:Report Sixth 38 (100%) 38 Complete Complete postabortion 87 (98%) 87 (96%) 49 abortion - Natal, South Africa Africa South Natal, , PhD report L. Administration of the - 2012/world etonogestrel 1 Obstet placement. placement. - acting reversibleacting contraception Buckel Gynecol. 2011Gynecol. - - - 3. report up , C., implant in women women in implant Obstet Incomplete abortion Secura - - 2 (2%) 2 (4%) Mothers 2012 Gynecol. 2012 2012 Gynecol. etonogestrel 0 - - , G. M., & south Lower Lower - 2011 - -