{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:18:20Z","timestamp":1770905900263,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,7,18]],"date-time":"2014-07-18T00:00:00Z","timestamp":1405641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"crossref","award":["521-2009-2605"],"award-info":[{"award-number":["521-2009-2605"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess nurse\u2010midwife provision of early medical termination of pregnancy (<jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>) in a high\u2010resource setting where ultrasound examination for dating of pregnancy is part of the protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Randomised controlled equivalence trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Out\u2010patient family planning unit at a university hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women seeking early medical <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1180 women were randomised, without any prior examination, to counselling, examination, and treatment by either nurse\u2010midwife or gynaecologist. Ultrasound was performed in all cases by the allocated provider.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The primary outcome was efficacy, defined as the successful completion of <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> without need for vacuum aspiration. Secondary outcomes were safety, defined as need for hospitalisation or blood transfusion, and acceptability, defined as preferred provider were the women to have a medical <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> in the future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 481 women in the nurse\u2010midwife group and 457 women in the doctor group were available for the final analysis. The effectiveness of provision of medical <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> by nurse\u2010midwife providers was superior to that provided by doctors (risk difference 1.6%, 95%\u00a0confidence interval 0.2\u20133.0%, which was within the set margin of equivalence). There were no significant differences in safety parameters. Women examined and counselled by a nurse\u2010midwife were significantly more likely (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001, 95% confidence interval 0.308\u20130.394) to prefer seeing a nurse\u2010midwife for the consultation were they to have another medical <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> in the future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings show that nurse\u2010midwife provision of early medical <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> in a high\u2010resource setting, where ultrasound is part of the protocol, is effective, and can be safely implemented with high acceptability among women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12982","type":"journal-article","created":{"date-parts":[[2014,7,18]],"date-time":"2014-07-18T10:26:51Z","timestamp":1405679211000},"page":"510-517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["The efficacy, safety and acceptability of medical termination of pregnancy provided by standard care by doctors or by nurse\u2010midwives: a randomised controlled equivalence trial"],"prefix":"10.1111","volume":"122","author":[{"given":"H","family":"Kopp Kallner","sequence":"first","affiliation":[{"name":"Division of Obstetrics and Gynaecology Department of Women's and Children's Health Karolinska Institutet Karolinska University Hospital Stockholm Sweden"},{"name":"Department of Obstetrics and Gynaecology Department of Clinical Sciences at Danderyd Hospital Karolinska Institutet Stockholm 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Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Marions","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology Department of Women's and Children's Health Karolinska Institutet Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Gemzell\u2010Danielsson","sequence":"additional","affiliation":[{"name":"Division of Obstetrics and Gynaecology Department of Women's and Children's Health Karolinska Institutet Karolinska University Hospital Stockholm 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