At-home urine pregnancy test assessment after mifepristone and misoprostol for undesired pregnancy of unknown location

Abstract

Objectives: The ideal assessment after mifepristone and misoprostol for undesired pregnancy of unknown location (PUL) is unknown.

Study design: We prospectively followed patients at Planned Parenthood League of Massachusetts (2019-2021) with PUL who received immediate mifepristone and misoprostol with serial at-home urine pregnancy tests (UPT) and in-office serum HCGs.

Results: Of 13 patients, 10 had a successful medication abortion. For those who completed UPTs (N = 9), all were negative by Day 14. Two abnormal pregnancies had positive UPTs on Day 14.

Conclusion: A negative UPT on Day 14 may help determine complete abortion after medication abortion for undesired PUL. A positive UPT on Day 14 warrants further evaluation.

Implication: Patients taking mifepristone and misoprostol in the setting of undesired PUL who cannot access serum testing may consider an at-home UPT to confirm complete abortion.

Keywords: Follow-up; Medication abortion; Pregnancy of unknown location; Urine pregnancy test.