American Journal of Obstetrics & Gynecology
Volume 202, Issue 6 , Pages 531.e1-531.e8, June 2010

Provider knowledge, attitudes, and treatment preferences for early pregnancy failure

Presented at the 57th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists, Chicago, IL, May 2-6, 2009, and Reproductive Health 2009, a joint meeting of the Association of Reproductive Health Professionals, the Planned Parenthood Federation of America National Medical Committee, and the Society of Family Planning, Los Angeles, CA, Sept. 30-Oct. 3, 2009.

  • Vanessa K. Dalton, MD, MPH

      Affiliations

    • Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI
    • Corresponding Author InformationReprints: Vanessa K. Dalton, MD, MPH, Department of Obstetrics and Gynecology, L4000 Women's Hospital, University of Michigan Medical School, 1500 E. Medical Center Dr., Ann Arbor, MI 48109
    • ,
  • Lisa H. Harris, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI
    • ,
  • Katherine J. Gold, MD

      Affiliations

    • Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI
    • ,
  • Lisa Kane-Low, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI
    • ,
  • Jay Schulkin, PhD

      Affiliations

    • Department of Research, American College of Obstetricians and Gynecologists, Washington, DC
    • ,
  • Ken Guire, MS

      Affiliations

    • Department of Biostatistics, University of Michigan Medical School, Ann Arbor, MI
    • ,
  • A. Mark Fendrick, MD

      Affiliations

    • Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI

Received 9 October 2009; received in revised form 9 December 2009; accepted 8 February 2010. published online 15 March 2010.

Objective

We sought to describe health care provider knowledge, attitudes, and treatment preferences for early pregnancy failure (EPF).

Study Design

We surveyed 976 obstetrician/gynecologists, midwives, and family medicine practitioners on their knowledge and attitudes toward treatment options for EPF, and barriers to adopting misoprostol and office uterine evacuations. We used descriptive statistics to compare practices by provider specialty and logistic regression to identify associations between provider factors and treatment practices.

Results

Seventy percent of providers have not used misoprostol and 91% have not used an office uterine evacuation to treat EPF in the past 6 months. Beliefs about safety and patient preferences, and prior induced abortion training were significantly associated with use of both of these treatments.

Conclusion

Increasing education and training on the use of misoprostol and office uterine evacuation, and clarifying patient treatment preferences may increase the willingness of providers to adopt new practices for EPF treatment.

Key words: early pregnancy failure, provider attitudes, treatment patterns

 

 Dr Dalton and this project were supported by Grant no. 1 K08 JS015491 from the Agency for Healthcare Research and Quality. Dr Schulkin is supported by a grant from the Health Resources and Services Administration.

 Cite this article as: Dalton VK, Harris LH, Gold KJ, et al. Provider knowledge, attitudes, and treatment preferences for early pregnancy failure. Am J Obstet Gynecol 2010;202:531.e1-8.

PII: S0002-9378(10)00221-8

doi:10.1016/j.ajog.2010.02.016

American Journal of Obstetrics & Gynecology
Volume 202, Issue 6 , Pages 531.e1-531.e8, June 2010

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