du.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Post-abortion care with misoprostol - equally effective, safe and accepted when administered by midwives compared to physicians: a randomised controlled equivalence trial in a low-resource setting in Kenya
Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.ORCID-id: 0000-0002-8947-2949
Visa övriga samt affilieringar
2017 (Engelska)Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, nr 10, artikel-id e016157Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: To assess the effectiveness of midwives administering misoprostol to women with incomplete abortion seeking post-abortion care (PAC), compared with physicians.

DESIGN: A multicentre randomised controlled equivalence trial. The study was not masked.

SETTINGS: Gynaecological departments in two hospitals in a low-resource setting, Kenya.

POPULATION: Women (n=1094) with incomplete abortion in the first trimester, seeking PAC between 1 June 2013 to 31 May 2016. Participants were randomly assigned to receive treatment from midwives or physicians. 409 and 401 women in the midwife and physician groups, respectively, were included in the per-protocol analysis.

INTERVENTIONS: 600 µg misoprostol orally, and contraceptive counselling by a physician or midwife.

MAIN OUTCOME MEASURES: Complete abortion not needing surgical intervention within 7-10 days. The main outcome was analysed on the per-protocol population with a generalised estimating equation model. The predefined equivalence range was -4% to 4%. Secondary outcomes were analysed descriptively.

RESULTS: The proportion of complete abortion was 94.8% (768/810): 390 (95.4%) in the midwife group and 378 (94.3%) in the physician group. The proportion of incomplete abortion was 5.2% (42/810), similarly distributed between midwives and physicians. The model-based risk difference for midwives versus physicians was 1.0% (-4.1 to 2.2). Most women felt safe (97%; 779/799), and 93% (748/801) perceived the treatment as expected/easier than expected. After contraceptive counselling the uptake of a contraceptive method after 7-10 days occurred in 76% (613/810). No serious adverse events were recorded.

CONCLUSIONS: Treatment of incomplete abortion with misoprostol provided by midwives is equally effective, safe and accepted by women as when administered by physicians in a low-resource setting. Systematically provided contraceptive counselling in PAC is effective to mitigate unmet need for contraception.

TRIAL REGISTRATION NUMBER: NCT01865136; Results.

Ort, förlag, år, upplaga, sidor
2017. Vol. 7, nr 10, artikel-id e016157
Nyckelord [en]
Community Gynaecology, Health Policy, Maternal Medicine, Reproductive Medicine
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
URN: urn:nbn:se:du-26432DOI: 10.1136/bmjopen-2017-016157ISI: 000422617500060PubMedID: 29018067Scopus ID: 2-s2.0-85031304432OAI: oai:DiVA.org:du-26432DiVA, id: diva2:1150137
Tillgänglig från: 2017-10-18 Skapad: 2017-10-18 Senast uppdaterad: 2018-02-02Bibliografiskt granskad

Open Access i DiVA

fulltext(653 kB)67 nedladdningar
Filinformation
Filnamn FULLTEXT01.pdfFilstorlek 653 kBChecksumma SHA-512
5f00f3773030f46b08b4cefaf248d34dc015eb4e6f1a4a683aa7ddd0e4b18df5107fafa312c661eb124716a2e106bf1403fd1ab04b36a08bef737973c2619348
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMedScopus

Personposter BETA

Klingberg-Allvin, Marie

Sök vidare i DiVA

Av författaren/redaktören
Klingberg-Allvin, Marie
Av organisationen
Omvårdnad
I samma tidskrift
BMJ Open
Hälsovetenskaper

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 67 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 173 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf