Background: Low
health literacy is associated with poor reproductive health outcomes. Previous
research on patient compliance with methotrexate protocols as treatment for
ectopic pregnancy has shown poor compliance (as low as 10%). Rates of
follow up after diagnosis with pregnancy of unknown location are not well
described.
Methods: A chart
review was performed to identify of all patients seen in an inner city hospital
with the diagnosis of pregnancy of unknown location. Patients meeting inclusion
criteria were contacted by phone to survey understanding of the rationale for
close follow up. Patients who never followed up after initial contact were
excluded.
Results: Eighty
seven patients with the diagnosis of pregnancy of unknown location were
identified between January – April 2018. Twenty nine patients met
inclusion criteria and twenty agreed to participate. Only 40% of patients correctly
explained that there was a concern for ectopic pregnancy. The remaining
patients identified their diagnosis as an “abnormal pregnancy” (10%),
“miscarriage” (10%); “I don’t know” (15%), and other (25%).
Discussions: Although the patients
surveyed were compliant with follow up, nearly half of the patients showed poor
comprehension of their clinical condition. It may be that poor understanding is
a major underlying cause for noncompliance for the many patients who never
followed up. This should be evaluated in future research.
Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, GME, Quality & Safety, Public Health, General Ob-Gyn,
Yiran Xu,
MD, Temple
University Hospital; Sarah Ackroyd, MD, MPH;
Molli Bascom,
MD; Sarah
Bruce, BA;
Margaret Rush,
BS; Kathryne
Sanserino, MD