Outcomes with dilatation and evacuation with and without feticide: a service evaluation
Feticide with intra-cardiac potassium chloride is routinely performed at BPAS before D&E at 22 weeks gestation or greater and in some cases at lower gestations. This service evaluation will assess D&E outcomes with and without feticide using a "before and after" or double cohort design.
In the first half of the year, BPAS' D&E service will continue as usual and in the second half, feticide will be discontinued. Data will be collected on outcomes, including safety and efficiency, of all D&E procedures. In addition, we will survey women and staff about the acceptability of feticide and their experiences of an options about its use. This project is funded by the Society of Family Planning.
Patricia A. Lohr, John Parsons, Chelsea Morroni, Jeanette Taylor
International observational e-registry on the use of Dilapan-S/Dilasoft osmotic dilators for cervical priming prior to termination of pregnancy
The aim of this study is to obtain more data on the optimal time to leave osmotic dilators in situ, the number of dilators to use at different gestational ages, when termination of pregnancy can be provided, and the impact of these parameters on clinical outcomes. We hope to confirm that the use of Dilapan-S/Dilasoft meets the expected efficacy and safety outcomes and to confirm the recommendations provided in the product instructions for use. This will be done by collecting data in an e-registry from a range of providers in different countries. As the study is international and multicentre, we will be able to compare the clinical practice of using dilators within the other study sites to learn more about the impact of different clinical practices on clinical outcomes.
Prospective observational study to assess clinical follow-up and outcomes of pregnancies exposed to ellaOne
EllaOne (ulipristal acetate 30 mg tablet) is a selective progesterone modulator with antagonistic and partial agonist effects at the progesterone receptor. It is licensed for use as an oral emergency contraceptive that can be taken up to 120 hours after unprotected sexual intercourse.
During the clinical development phase, only a small number of pregnancies occurred following administration of ellaOne leading the European Medicines Agency and US Food and Drug Administration to request additional information on the potential effects of ellaOne exposure on pregnancy course and outcome. The manufacturer of ellaOne, HRA Pharma, have implemented a prospective multisite observational study (in the US and UK) to collate data on pregnancies that are carried to term and delivered, those that miscarry, and those that are terminated. BPAS’ participation will be limited to providing data on women in the latter two groups.
Experiences of Irish Women Seeking Abortion Care in the United Kingdom
seeks to examine reproductive health travel to the United Kingdom (UK), focusing on women who travel from the Republic of Ireland to the UK for an abortion. Irish women’s experiences and perspectives are poorly understood. Stories from women who shared their experiences publicly tend to highlight the tragic nature of their circumstances, in particular in cases of severe fetal abnormalities. However, it is also clear that the circumstances of women who seek this care vary and many have ordinary circumstances for seeking abortion. This project aims to better understand the experiences of the latter group by using a systematic qualitative research approach.
Two research questions guide this study: (1) What are the challenges faced by Irish women travelling to the UK for abortion care (including in terms of resources, the need to conceal travel, and consequences for work, family, and social life) and how do women navigate these challenges?, and, (2) What is the nature of any delays in receiving abortion care that these women experience? This research is being conducted by Joanna Mishtal, PhD, Associate Professor of anthropology based at the University of Central Florida, and current Visiting Fellow at Kent University, Kent Centre for Law, Gender and Sexuality - Kent Law School.
Dilation and evacuation between 15 and 24 weeks gestation: An analysis of procedures and outcomes over 2 years
This audit will describe outcomes with D&E at 15-24 weeks gestation performed by BPAS from 1st April 2011 and 31st March 2013. Based on annual procedure statistics, a review over 2 years will total approximately 9,500 cases.
The specific aim is to describe outcomes and to identify factors associated with major, minor, immediate and delayed complications of D&E. A secondary outcome is to identify socio-demographic, reproductive health and procedure-related characteristics associated with complications.
Patricia A. Lohr, Chelsea Morroni, Richard Lyus, Jeanette Taylor