Objective
This
study aimed to assess women´s acceptability of diagnosis and treatment of
incomplete abortion with misoprostol by midwives, compared with physicians.
Methods
This
was an analysis of secondary outcomes from a multi-centre randomized controlled
equivalence trial at district level in Uganda. Women with first trimester
incomplete abortion were randomly allocated to clinical assessment and
treatment with misoprostol by a physician or a midwife. The randomisation (1:1)
was done in blocks of 12 and stratified for health care facility. Acceptability
was measured in expectations and satisfaction at a follow up visit 14–28 days
following treatment. Analysis of women’s overall acceptability was done using a
generalized linear mixed-effects model with an equivalence range of -4% to 4%.
The study was not masked. The trial is registered at ClinicalTrials.org, NCT
01844024.
Results
From
April 2013 to June 2014, 1108 women were assessed for eligibility of which 1010
were randomized (506 to midwife and 504 to physician). 953 women were
successfully followed up and included in the acceptability analysis. 95% (904)
of the participants found the treatment satisfactory and overall acceptability was
found to be equivalent between the two study groups. Treatment failure, not
feeling calm and safe following treatment, experiencing severe abdominal pain
or heavy bleeding following treatment, were significantly associated with
non-satisfaction. No serious adverse events were recorded.
Conclusions
Treatment of incomplete abortion with misoprostol by
midwives and physician was highly, and equally, acceptable to women.
Full article at: http://goo.gl/7ux4pg
By:
Amanda Cleeve, Kristina Gemzell-Danielsson, Marie
Klingberg-Allvin
Department of Women’s and Children’s Health, Karolinska
Institutet, Stockholm, Sweden
Amanda Cleeve, Kristina Gemzell-Danielsson
WHO Center for Human Reproduction, Karolinska University
Hospital, Stockholm, Sweden
Josaphat Byamugisha, Susan Atuhairwe
Department of Obstetrics and Gynaecology, Mulago Hospital,
Kampala, Uganda
Josaphat Byamugisha, Susan Atuhairwe
Department of Obstetrics and Gynaecology, Makerere
University College of Health Sciences, Kampala, Uganda
Nazarius Mbona Tumwesigye
Department of Epidemiology and Biostatistics, School of
Public Health, Makerere University, Kampala, Uganda
Elisabeth Faxelid
Department of Public Health Sciences, Global Health (IHCAR),
Karolinska Institutet, Stockholm, Sweden
Marie Klingberg-Allvin
School of Education, Health and Social Studies, Dalarna
University, Falun, Sweden
More at: https://twitter.com/hiv insight
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