Analysis of uterine evacuation methods in postabortion care after implementation of a surveillance network (CLAP MUSA-Network) at a university hospital
Management of uterine evacuation is essential for increasing safe abortion care. Monitoring through surveillance systems tracks changes in clinical practice and provides information to improve equity in abortion care quality. This study aimed to evaluate the frequency of manual vacuum aspiration (MV...
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| creator | Veiga-Junior, Nelio N Eugeni, Caroline Kajiura, Beatriz D F Dantas, Priscilla B Trabach, Caroline B Junqueira, Aline A Nunes, Carina C Baccaro, Luiz F |
| description | Management of uterine evacuation is essential for increasing safe abortion care. Monitoring through surveillance systems tracks changes in clinical practice and provides information to improve equity in abortion care quality.
This study aimed to evaluate the frequency of manual vacuum aspiration (MVA) and medical abortion (MA), and identify the factors associated with each uterine evacuation method after surveillance network installation at a Brazilian hospital.
This cross-sectional study included women admitted for abortion or miscarriage to the University of Campinas Women's Hospital, Brazil, between July 2017 and November 2020. The dependent variables were the use of MVA and MA with misoprostol. The independent variables were the patients' clinical and sociodemographic data. The Cochran-Armitage, chi-square, and Mann-Whitney U tests, as well as multiple logistic regression analysis, were used to compare uterine evacuation methods.
We enrolled 474 women in the study, 91.35% of whom underwent uterine evacuation via uterine curettage (78.75%), MVA (9.46%), or MA (11.54%). MVA use increased during the study period (Z = 9.85, p < 0.001). Admission in 2020 (odds ratio [OR] 64.22; 95% confidence interval [CI] 3.79-1086.69) and lower gestational age (OR 0.837; 95% CI 0.724-0.967) were independently associated with MVA, whereas the only factor independently associated with MA was a higher education level (OR 2.66; 95% CI 1.30-5.46).
MVA use increased following the installation of a surveillance network for good clinical practice. Being part of a network that encourages the use of evidence-based methods provides an opportunity for healthcare facilities to increase access to safe abortions. |
| doi_str_mv | 10.1371/journal.pone.0296009 |
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This study aimed to evaluate the frequency of manual vacuum aspiration (MVA) and medical abortion (MA), and identify the factors associated with each uterine evacuation method after surveillance network installation at a Brazilian hospital.
This cross-sectional study included women admitted for abortion or miscarriage to the University of Campinas Women's Hospital, Brazil, between July 2017 and November 2020. The dependent variables were the use of MVA and MA with misoprostol. The independent variables were the patients' clinical and sociodemographic data. The Cochran-Armitage, chi-square, and Mann-Whitney U tests, as well as multiple logistic regression analysis, were used to compare uterine evacuation methods.
We enrolled 474 women in the study, 91.35% of whom underwent uterine evacuation via uterine curettage (78.75%), MVA (9.46%), or MA (11.54%). MVA use increased during the study period (Z = 9.85, p < 0.001). Admission in 2020 (odds ratio [OR] 64.22; 95% confidence interval [CI] 3.79-1086.69) and lower gestational age (OR 0.837; 95% CI 0.724-0.967) were independently associated with MVA, whereas the only factor independently associated with MA was a higher education level (OR 2.66; 95% CI 1.30-5.46).
MVA use increased following the installation of a surveillance network for good clinical practice. Being part of a network that encourages the use of evidence-based methods provides an opportunity for healthcare facilities to increase access to safe abortions.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0296009</identifier><identifier>PMID: 38100497</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abortion ; Abortion, Induced - methods ; Abortion, Spontaneous ; Aftercare - methods ; Clinical medicine ; Confidence intervals ; Consent ; Cross-Sectional Studies ; Curettage ; Data collection ; Dependent variables ; Education ; Evacuation ; Female ; Gestational age ; Health aspects ; Health care facilities ; Hospitalization ; Hospitals ; Hospitals, University ; Humans ; Independent variables ; Maternal mortality ; Methods ; Misoprostol ; Morbidity ; Musa ; Pregnancy ; Regression analysis ; Research ethics ; Sociodemographics ; Statistical analysis ; Surveillance ; Surveillance systems ; Uterus ; Vacuum Curettage ; Variables ; Women ; Womens health</subject><ispartof>PloS one, 2023-12, Vol.18 (12), p.e0296009-e0296009</ispartof><rights>Copyright: © 2023 Veiga-Junior et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Veiga-Junior et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Veiga-Junior et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c487t-721c2c99256f6e9e1470909a0631c447b6998a2915d4ef486e7c7ddfc90b81eb3</cites><orcidid>0000-0002-8837-8061</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0296009&type=printable$$EPDF$$P50$$Gplos$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0296009$$EHTML$$P50$$Gplos$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,864,2100,2926,23864,27922,27923,79370,79371</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38100497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Dangal, Ganesh</contributor><creatorcontrib>Veiga-Junior, Nelio N</creatorcontrib><creatorcontrib>Eugeni, Caroline</creatorcontrib><creatorcontrib>Kajiura, Beatriz D</creatorcontrib><creatorcontrib>F Dantas, Priscilla B</creatorcontrib><creatorcontrib>Trabach, Caroline B</creatorcontrib><creatorcontrib>Junqueira, Aline A</creatorcontrib><creatorcontrib>Nunes, Carina C</creatorcontrib><creatorcontrib>Baccaro, Luiz F</creatorcontrib><title>Analysis of uterine evacuation methods in postabortion care after implementation of a surveillance network (CLAP MUSA-Network) at a university hospital</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Management of uterine evacuation is essential for increasing safe abortion care. Monitoring through surveillance systems tracks changes in clinical practice and provides information to improve equity in abortion care quality.
This study aimed to evaluate the frequency of manual vacuum aspiration (MVA) and medical abortion (MA), and identify the factors associated with each uterine evacuation method after surveillance network installation at a Brazilian hospital.
This cross-sectional study included women admitted for abortion or miscarriage to the University of Campinas Women's Hospital, Brazil, between July 2017 and November 2020. The dependent variables were the use of MVA and MA with misoprostol. The independent variables were the patients' clinical and sociodemographic data. The Cochran-Armitage, chi-square, and Mann-Whitney U tests, as well as multiple logistic regression analysis, were used to compare uterine evacuation methods.
We enrolled 474 women in the study, 91.35% of whom underwent uterine evacuation via uterine curettage (78.75%), MVA (9.46%), or MA (11.54%). MVA use increased during the study period (Z = 9.85, p < 0.001). Admission in 2020 (odds ratio [OR] 64.22; 95% confidence interval [CI] 3.79-1086.69) and lower gestational age (OR 0.837; 95% CI 0.724-0.967) were independently associated with MVA, whereas the only factor independently associated with MA was a higher education level (OR 2.66; 95% CI 1.30-5.46).
MVA use increased following the installation of a surveillance network for good clinical practice. Being part of a network that encourages the use of evidence-based methods provides an opportunity for healthcare facilities to increase access to safe abortions.</description><subject>Abortion</subject><subject>Abortion, Induced - methods</subject><subject>Abortion, Spontaneous</subject><subject>Aftercare - methods</subject><subject>Clinical medicine</subject><subject>Confidence intervals</subject><subject>Consent</subject><subject>Cross-Sectional Studies</subject><subject>Curettage</subject><subject>Data collection</subject><subject>Dependent variables</subject><subject>Education</subject><subject>Evacuation</subject><subject>Female</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Health care facilities</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Independent variables</subject><subject>Maternal 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of uterine evacuation methods in postabortion care after implementation of a surveillance network (CLAP MUSA-Network) at a university hospital</title><author>Veiga-Junior, Nelio N ; Eugeni, Caroline ; Kajiura, Beatriz D ; F Dantas, Priscilla B ; Trabach, Caroline B ; Junqueira, Aline A ; Nunes, Carina C ; Baccaro, Luiz F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c487t-721c2c99256f6e9e1470909a0631c447b6998a2915d4ef486e7c7ddfc90b81eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abortion</topic><topic>Abortion, Induced - methods</topic><topic>Abortion, Spontaneous</topic><topic>Aftercare - methods</topic><topic>Clinical medicine</topic><topic>Confidence intervals</topic><topic>Consent</topic><topic>Cross-Sectional Studies</topic><topic>Curettage</topic><topic>Data collection</topic><topic>Dependent 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B</au><au>Trabach, Caroline B</au><au>Junqueira, Aline A</au><au>Nunes, Carina C</au><au>Baccaro, Luiz F</au><au>Dangal, Ganesh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of uterine evacuation methods in postabortion care after implementation of a surveillance network (CLAP MUSA-Network) at a university hospital</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-12-15</date><risdate>2023</risdate><volume>18</volume><issue>12</issue><spage>e0296009</spage><epage>e0296009</epage><pages>e0296009-e0296009</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Management of uterine evacuation is essential for increasing safe abortion care. Monitoring through surveillance systems tracks changes in clinical practice and provides information to improve equity in abortion care quality.
This study aimed to evaluate the frequency of manual vacuum aspiration (MVA) and medical abortion (MA), and identify the factors associated with each uterine evacuation method after surveillance network installation at a Brazilian hospital.
This cross-sectional study included women admitted for abortion or miscarriage to the University of Campinas Women's Hospital, Brazil, between July 2017 and November 2020. The dependent variables were the use of MVA and MA with misoprostol. The independent variables were the patients' clinical and sociodemographic data. The Cochran-Armitage, chi-square, and Mann-Whitney U tests, as well as multiple logistic regression analysis, were used to compare uterine evacuation methods.
We enrolled 474 women in the study, 91.35% of whom underwent uterine evacuation via uterine curettage (78.75%), MVA (9.46%), or MA (11.54%). MVA use increased during the study period (Z = 9.85, p < 0.001). Admission in 2020 (odds ratio [OR] 64.22; 95% confidence interval [CI] 3.79-1086.69) and lower gestational age (OR 0.837; 95% CI 0.724-0.967) were independently associated with MVA, whereas the only factor independently associated with MA was a higher education level (OR 2.66; 95% CI 1.30-5.46).
MVA use increased following the installation of a surveillance network for good clinical practice. Being part of a network that encourages the use of evidence-based methods provides an opportunity for healthcare facilities to increase access to safe abortions.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38100497</pmid><doi>10.1371/journal.pone.0296009</doi><orcidid>https://orcid.org/0000-0002-8837-8061</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2023-12, Vol.18 (12), p.e0296009-e0296009 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3072931397 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Abortion Abortion, Induced - methods Abortion, Spontaneous Aftercare - methods Clinical medicine Confidence intervals Consent Cross-Sectional Studies Curettage Data collection Dependent variables Education Evacuation Female Gestational age Health aspects Health care facilities Hospitalization Hospitals Hospitals, University Humans Independent variables Maternal mortality Methods Misoprostol Morbidity Musa Pregnancy Regression analysis Research ethics Sociodemographics Statistical analysis Surveillance Surveillance systems Uterus Vacuum Curettage Variables Women Womens health |
| title | Analysis of uterine evacuation methods in postabortion care after implementation of a surveillance network (CLAP MUSA-Network) at a university hospital |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-10T02%3A24%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Analysis%20of%20uterine%20evacuation%20methods%20in%20postabortion%20care%20after%20implementation%20of%20a%20surveillance%20network%20(CLAP%20MUSA-Network)%20at%20a%20university%20hospital&rft.jtitle=PloS%20one&rft.au=Veiga-Junior,%20Nelio%20N&rft.date=2023-12-15&rft.volume=18&rft.issue=12&rft.spage=e0296009&rft.epage=e0296009&rft.pages=e0296009-e0296009&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0296009&rft_dat=%3Cgale_plos_%3EA776400921%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3072931397&rft_id=info:pmid/38100497&rft_galeid=A776400921&rft_doaj_id=oai_doaj_org_article_f8af637f408a4da38bcfa2de59d25535&rfr_iscdi=true |