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Evaluation of Pain and Use of Analgesics during Medical Termination of Pregnancy in Real-Life Settings
INTRODUCTION: Women frequently report pain associated with medical termination of pregnancy (MToP), and its management can differ largely between centres. This study aimed at evaluating in real-life settings pain related to MToP and its management in France. METHODS: This was a non-interventional pr...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10036711/ https://www.ncbi.nlm.nih.gov/pubmed/36840805 http://dx.doi.org/10.1007/s40122-023-00477-2 |
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author | Agostini, Aubert Miquel, Laura Herman-Demars, Hélène Frantz, Sandrine Sicot, Marie |
author_facet | Agostini, Aubert Miquel, Laura Herman-Demars, Hélène Frantz, Sandrine Sicot, Marie |
author_sort | Agostini, Aubert |
collection | PubMed |
description | INTRODUCTION: Women frequently report pain associated with medical termination of pregnancy (MToP), and its management can differ largely between centres. This study aimed at evaluating in real-life settings pain related to MToP and its management in France. METHODS: This was a non-interventional prospective, longitudinal study run in 23 centres between 2015 and 2016 that included 893 pregnant women. Pain was reported by women prior any curative analgesic intake (CAI) through a five-level Likert scale (absence, mild, moderated, severe, extreme). Modalities of analgesic prophylaxis prescription (APP) and intake (API) and CAI were collected. Risk factors were investigated using ordinal logistic regression (for pain) or logistic regression (for CAI) with stepwise selection of variables. RESULTS: APP was prescribed to 657 (73.7%) women irrespective of the gestational age, among whom 386 (73.7%) took the treatment. Out of 740 women who documented their pain symptoms prior to any CAI, few declared no pain (n = 94, 12.7%) or intense pain (n = 88, 11.9%). The majority reported mild or moderate pain (n = 558, 75.4%). On multivariate analysis adjusted on gestational age, increasing initial [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.06–1.47] or total dose (OR 1.15, 95% CI 1.05–1.26) of misoprostol taken were independent factors associated with risk of more pain. When adjusting for gestational age, initial dose of misoprostol (OR 1.69, 95% CI 1.45–2.66) and pain experienced (OR 3.58, 95% CI 2.82–4.55) were significantly associated with higher risk of CAI while API (OR 0.52, 95% CI 0.36; 0.75) was negatively associated. CONCLUSIONS: Most of the women received an APP, but not all used it. API and gestational age were not related to different risks of more pain following MToP, whereas history of at least one child showed a negative association. Higher doses of misoprostol were strongly associated with both pain and CAI. API was associated with a decreased risk of CAI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40122-023-00477-2. |
format | Online Article Text |
id | pubmed-10036711 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-100367112023-03-25 Evaluation of Pain and Use of Analgesics during Medical Termination of Pregnancy in Real-Life Settings Agostini, Aubert Miquel, Laura Herman-Demars, Hélène Frantz, Sandrine Sicot, Marie Pain Ther Original Research INTRODUCTION: Women frequently report pain associated with medical termination of pregnancy (MToP), and its management can differ largely between centres. This study aimed at evaluating in real-life settings pain related to MToP and its management in France. METHODS: This was a non-interventional prospective, longitudinal study run in 23 centres between 2015 and 2016 that included 893 pregnant women. Pain was reported by women prior any curative analgesic intake (CAI) through a five-level Likert scale (absence, mild, moderated, severe, extreme). Modalities of analgesic prophylaxis prescription (APP) and intake (API) and CAI were collected. Risk factors were investigated using ordinal logistic regression (for pain) or logistic regression (for CAI) with stepwise selection of variables. RESULTS: APP was prescribed to 657 (73.7%) women irrespective of the gestational age, among whom 386 (73.7%) took the treatment. Out of 740 women who documented their pain symptoms prior to any CAI, few declared no pain (n = 94, 12.7%) or intense pain (n = 88, 11.9%). The majority reported mild or moderate pain (n = 558, 75.4%). On multivariate analysis adjusted on gestational age, increasing initial [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.06–1.47] or total dose (OR 1.15, 95% CI 1.05–1.26) of misoprostol taken were independent factors associated with risk of more pain. When adjusting for gestational age, initial dose of misoprostol (OR 1.69, 95% CI 1.45–2.66) and pain experienced (OR 3.58, 95% CI 2.82–4.55) were significantly associated with higher risk of CAI while API (OR 0.52, 95% CI 0.36; 0.75) was negatively associated. CONCLUSIONS: Most of the women received an APP, but not all used it. API and gestational age were not related to different risks of more pain following MToP, whereas history of at least one child showed a negative association. Higher doses of misoprostol were strongly associated with both pain and CAI. API was associated with a decreased risk of CAI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40122-023-00477-2. Springer Healthcare 2023-02-25 2023-04 /pmc/articles/PMC10036711/ /pubmed/36840805 http://dx.doi.org/10.1007/s40122-023-00477-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Agostini, Aubert Miquel, Laura Herman-Demars, Hélène Frantz, Sandrine Sicot, Marie Evaluation of Pain and Use of Analgesics during Medical Termination of Pregnancy in Real-Life Settings |
title | Evaluation of Pain and Use of Analgesics during Medical Termination of Pregnancy in Real-Life Settings |
title_full | Evaluation of Pain and Use of Analgesics during Medical Termination of Pregnancy in Real-Life Settings |
title_fullStr | Evaluation of Pain and Use of Analgesics during Medical Termination of Pregnancy in Real-Life Settings |
title_full_unstemmed | Evaluation of Pain and Use of Analgesics during Medical Termination of Pregnancy in Real-Life Settings |
title_short | Evaluation of Pain and Use of Analgesics during Medical Termination of Pregnancy in Real-Life Settings |
title_sort | evaluation of pain and use of analgesics during medical termination of pregnancy in real-life settings |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10036711/ https://www.ncbi.nlm.nih.gov/pubmed/36840805 http://dx.doi.org/10.1007/s40122-023-00477-2 |
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