"Influence Of Previous Cesarean Section On Clinical Outcome Of Medicati" by Lauren Pellegrino

Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Master of Science in Nursing (MSN)

Department

Yale University School of Nursing

First Advisor

Ivy M. Alexander

Abstract

A retrospective chart review was conducted to assess for a relationship between previous Cesarean section delivery and failure of subsequent medication abortion. Several studies have shown a positive relationship between parity and failure of subsequent medication abortion; however, these studies did not isolate method of delivery (Cotte, Monniez, and Norel 2008; Ashok, Templeton, Wagaarachchi, & Flett, 2002; Niinimäki, Martikainen, and Talvensaari-Mattila, 2004; Bartley, Tong, Everington, & Baird, 2000). The sample was 196 women who underwent medication abortion and returned for a two week follow-up appointment at an urban women's health clinic during 2005-2010. The protocol for medication abortion was 200mg Mifepristone orally followed by 400mcg of misoprostol vaginally or buccally administered 12-24 hours later. Failure was defined as positive pregnancy test at follow-up. Demographic and outcome data was collected from patient self-report pre-procedure intake and follow-up questionnaire forms. Parity regardless of delivery type increased the risk of failure (p=0.0422) but previous Cesarean section did not (p = 0.6141). Duration of cramps experienced after Misoprostol insertion were negatively correlated with age (r = -0.25448). A positive correlation was found between longer cramp duration and smoking status. Future studies may benefit from a focus on other outcome measures--such as onset and duration of cramping or bleeding--rather than simply procedure failure or success, and a larger prospective study with formal clinician-guided measure is recommended.

Comments

This is an Open Access Thesis.

Open Access

This Article is Open Access

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