{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:45:49Z","timestamp":1793036749430,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T00:00:00Z","timestamp":1568764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>For many women, the need for multiple clinical visits is a barrier to medical abortion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We assessed the effectiveness, safety, and acceptability of self\u2010assessment of the outcome of medical abortion completed at home versus routine clinic follow up after medical abortion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>We searched databases such as MEDLINE, Embase, and <jats:styled-content style=\"fixed-case\">CENTRAL<\/jats:styled-content> to find studies published in 1991\u20132018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Eligible studies included women of reproductive age who had undergone a medical abortion that was completed at home. The intervention and self\u2010assessment of the outcome of medical abortion done by urine pregnancy tests kits by women at home was compared with routine medical follow up at a clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Two researchers completed the study selection, data extraction, critical appraisal, and assessment of the evidence. The outcomes were successful complete abortions, side effects and complications, and acceptability. We performed meta\u2010analyses when possible and <jats:styled-content style=\"fixed-case\">GRADE<\/jats:styled-content> to ascertain the certainty of the evidence. The protocol was registered in <jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">CRD<\/jats:styled-content>42017055316).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Four <jats:styled-content style=\"fixed-case\">randomised controlled trials (RCT<\/jats:styled-content>s; <jats:italic>n<\/jats:italic>\u00a0=\u00a05493) met our inclusion criteria. The pooled analysis from all studies showed no significant difference in complete abortion rates between self\u2010assessment and routine clinic follow up: <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\u00a0=\u00a01.00, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.99\u20131.01. The ongoing pregnancy rates were similar and the pooled results for the safety outcomes showed no significant differences between the groups. There was a significantly greater preference for self\u2010assessment as the follow\u2010up method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The effectiveness, safety, and acceptability of self\u2010assessment of the outcome of medical abortion completed at home are not inferior to routine clinic follow up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>The effectiveness, safety, and acceptability of self\u2010assessment of the outcome of medical abortion are not inferior to routine clinic follow up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15922","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T11:09:06Z","timestamp":1567249746000},"page":"1536-1544","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Effectiveness, safety and acceptability of self\u2010assessment of the outcome of first\u2010trimester medical abortion: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"126","author":[{"given":"N","family":"Baiju","sequence":"first","affiliation":[{"name":"Department of Community Medicine The Arctic University of Norway University of Troms\u00f8 (UiT) Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Acharya","sequence":"additional","affiliation":[{"name":"Women's Health and Perinatology Research Group Department of Clinical Medicine UiT and University Hospital of North Norway (UNN) Troms\u00f8 Norway"},{"name":"Division of Obstetrics and Gynecology Department of Clinical Science, Intervention and Technology Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"D'Antonio","sequence":"additional","affiliation":[{"name":"Women's Health and Perinatology Research Group Department of Clinical Medicine UiT and University Hospital of North Norway (UNN) Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RC","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Community Medicine The Arctic University of Norway University of Troms\u00f8 (UiT) Troms\u00f8 Norway"},{"name":"Department of Reviews and Health Technology Assessments Norwegian Institute of Public Health (NIPH) Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,18]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"11","article-title":"Self\u2010assessment of medical abortion outcome using symptoms and home pregnancy testing","volume":"11","author":"Raymond EG","year":"2017","journal-title":"Contraception"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.131320"},{"key":"e_1_2_6_4_1","first-page":"205","article-title":"Safe Abortion: Technical and Policy Guidance for Health Systems. 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