TY - JOUR T1 - Telemedicine medical abortion at home under 12 weeks’ gestation: a prospective observational cohort study during the COVID-19 pandemic JF - BMJ Sexual & Reproductive Health JO - BMJ Sex Reprod Health SP - 246 LP - 251 DO - 10.1136/bmjsrh-2020-200976 VL - 47 IS - 4 AU - John Joseph Reynolds-Wright AU - Anne Johnstone AU - Karen McCabe AU - Emily Evans AU - Sharon Cameron Y1 - 2021/10/01 UR - http://jfprhc.bmj.com/content/47/4/246.abstract N2 - Background In response to the COVID-19 pandemic, legislation and guidance were introduced in Scotland permitting medical abortion at home by telemedicine for pregnancies at less than 12 weeks’ gestation. Women had a telephone consultation with a clinician. Routine ultrasound was not performed. Medications and a low-sensitivity pregnancy test to confirm success of treatment were collected by or delivered to the woman, with telephone support provided as needed.Methods A prospective cohort study of 663 women choosing medical abortion at home via the NHS Lothian telemedicine abortion service between 1 April and 9 July 2020. Interviewer-administered questionnaires were completed 4 and 14 days following treatment. Regional hospital databases were reviewed to verify abortion outcomes and complications within 6 weeks. Outcome measures included efficacy, complications and acceptability.Results Almost all (642/663, 98.2%) the women were under 10 weeks’ gestation. For 522/663 (78.7%) women, gestation was determined using last menstrual period alone. Some 650/663 (98%) women had a complete abortion, 5 (0.8%) an ongoing pregnancy and 4 (0.6%) an incomplete abortion. No one was treated inadvertently beyond 12 weeks’ gestation, but one woman was never pregnant. One woman who had a pre-abortion ultrasound was later managed as a caesarean scar ectopic. There were two cases of haemorrhage and no severe infections. Some 123 (18.5%) women sought advice by telephone for a concern related to the abortion and 56 (8.4%) then attended a clinic for review. Most (628, 95%) women rated their care as very or somewhat acceptable.Conclusions This model of telemedicine abortion without routine ultrasound is safe, and has high efficacy and high acceptability among women.The original data are not available in a public repository. The corresponding author is to be contacted for the consideration of any data requests. ER -