Bizjak I, et al. – A cohort study is carried out to evaluate the effectiveness and safety of medical termination of pregnancy (MTOP) where no intrauterine pregnancy (IUP) is affirmed on ultrasound. The current study shows that no difference is seen between the groups in the efficacy of MTOP while early treatment resulted in significantly fewer interventions for incomplete TOP. The risk of ectopic pregnancy should be considered if treatment is initiated before an IUP is affirmed but with structured clinical protocols the possibility of early detection of an ectopic pregnancy in an asymptomatic phase may increase.

Methods

• For this research, they designed a retrospective case note review.
• This study is conducted at two gynecological clinics in Vienna, Austria and Gothenburg, Sweden.
• All women with gestations of ≤ 49 days undergoing an MTOP amid 2004–2014 (Vienna) and 2012–2015 (Gothenburg) are selected for this study.
• Two study cohorts are created; women with and women without a confirmed IUP.
• An IUP is characterized as an intrauterine location of a yolk sac or fetal structure visible by ultrasound.
• Women with an IUP are selected randomly and incorporated into the IUP–cohort.

Results

• In this study, they exclude 11 women diagnosed with an extra uterine or molar pregnancy.
• After excluding, total 2643 cases were included in the final analysis; 1120 (98.2%) had a successful TOP in the no–IUP group compared to 1458 (97.1%) in the IUP group, risk difference 1.09% [95% CI –0.14%, 2.32%], p–value 0.077.
• Significantly more women with confirmed IUP were diagnosed with incomplete TOP and treated with either surgery or additional medical treatment with misoprostol, (64/4.3%) versus (21/1.8%), risk difference –2.42% [95% CI –3.9%, –1.1%] p<0.001.