A retrospective chart review was conducted to assess for a relationship between previous Cesarean section delivery and failure of subsequent medication abortion. Several studies have shown a positive relationship between parity and failure of subsequent medication abortion; however, these studies did not isolate method of delivery (Cotte, Monniez, and Norel 2008; Ashok, Templeton, Wagaarachchi, & Flett, 2002; Niinimäki, Martikainen, and Talvensaari-Mattila, 2004; Bartley, Tong, Everington, & Baird, 2000). The sample was 196 women who underwent medication abortion and returned for a two week follow-up appointment at an urban women's health clinic during 2005-2010. The protocol for medication abortion was 200mg Mifepristone orally followed by 400mcg of misoprostol vaginally or buccally administered 12-24 hours later. Failure was defined as positive pregnancy test at follow-up. Demographic and outcome data was collected from patient self-report pre-procedure intake and follow-up questionnaire forms. Parity regardless of delivery type increased the risk of failure (p=0.0422) but previous Cesarean section did not (p = 0.6141). Duration of cramps experienced after Misoprostol insertion were negatively correlated with age (r = -0.25448). A positive correlation was found between longer cramp duration and smoking status. Future studies may benefit from a focus on other outcome measures--such as onset and duration of cramping or bleeding--rather than simply procedure failure or success, and a larger prospective study with formal clinician-guided measure is recommended.
","abstract_html":"<p>A retrospective chart review was conducted to assess for a relationship between previous Cesarean section delivery and failure of subsequent medication abortion. Several studies have shown a positive relationship between parity and failure of subsequent medication abortion; however, these studies did not isolate method of delivery (Cotte, Monniez, and Norel 2008; Ashok, Templeton, Wagaarachchi, & Flett, 2002; Niinimäki, Martikainen, and Talvensaari-Mattila, 2004; Bartley, Tong, Everington, & Baird, 2000). The sample was 196 women who underwent medication abortion and returned for a two week follow-up appointment at an urban women's health clinic during 2005-2010. The protocol for medication abortion was 200mg Mifepristone orally followed by 400mcg of misoprostol vaginally or buccally administered 12-24 hours later. Failure was defined as positive pregnancy test at follow-up. Demographic and outcome data was collected from patient self-report pre-procedure intake and follow-up questionnaire forms. Parity regardless of delivery type increased the risk of failure (p=0.0422) but previous Cesarean section did not (p = 0.6141). Duration of cramps experienced after Misoprostol insertion were negatively correlated with age (r = -0.25448). A positive correlation was found between longer cramp duration and smoking status. Future studies may benefit from a focus on other outcome measures--such as onset and duration of cramping or bleeding--rather than simply procedure failure or success, and a larger prospective study with formal clinician-guided measure is recommended.</p>","abstract_has_math":false,"creators":["Pellegrino, Lauren"],"institution":null,"degree_name":"Master of Science in Nursing (MSN)","degree_level":"Open Access Thesis","degree_discipline":"Yale University School of Nursing","degree_department":null,"school":null,"contributors":["Ivy M. Alexander"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2012,"date_issued":"2012-01-01T08:00:00Z","date_published":"2012-01-01T08:00:00Z","updated_at":"2026-07-24T06:16:00Z","subjects":["abortion, Adult Nurse Practitioner, Cesarean section, medication abortion, Women's Health"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://elischolar.library.yale.edu/ysndt/1007","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Ivy M. Alexander"]},{"key":"dc:creator","label":"Author","values":["Pellegrino, Lauren"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"thesis:degree_discipline","label":"Discipline","values":["Yale University School of Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Open Access Thesis"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Master of Science in Nursing (MSN)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["abortion, Adult Nurse Practitioner, Cesarean section, medication abortion, Women's Health"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://elischolar.library.yale.edu/ysndt/1007"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["A retrospective chart review was conducted to assess for a relationship between previous Cesarean section delivery and failure of subsequent medication abortion. Several studies have shown a positive relationship between parity and failure of subsequent medication abortion; however, these studies did not isolate method of delivery (Cotte, Monniez, and Norel 2008; Ashok, Templeton, Wagaarachchi, & Flett, 2002; Niinimäki, Martikainen, and Talvensaari-Mattila, 2004; Bartley, Tong, Everington, & Baird, 2000). The sample was 196 women who underwent medication abortion and returned for a two week follow-up appointment at an urban women's health clinic during 2005-2010. The protocol for medication abortion was 200mg Mifepristone orally followed by 400mcg of misoprostol vaginally or buccally administered 12-24 hours later. Failure was defined as positive pregnancy test at follow-up. Demographic and outcome data was collected from patient self-report pre-procedure intake and follow-up questionnaire forms. Parity regardless of delivery type increased the risk of failure (p=0.0422) but previous Cesarean section did not (p = 0.6141). Duration of cramps experienced after Misoprostol insertion were negatively correlated with age (r = -0.25448). A positive correlation was found between longer cramp duration and smoking status. Future studies may benefit from a focus on other outcome measures--such as onset and duration of cramping or bleeding--rather than simply procedure failure or success, and a larger prospective study with formal clinician-guided measure is recommended.
"]},{"key":"dc:title","label":"Title","values":["Influence Of Previous Cesarean Section On Clinical Outcome Of Medication Abortion"]}]}],"canonical_facts":{"dc:contributor":["Ivy M. Alexander"],"dc:creator":["Pellegrino, Lauren"],"dc:description.abstract":["A retrospective chart review was conducted to assess for a relationship between previous Cesarean section delivery and failure of subsequent medication abortion. Several studies have shown a positive relationship between parity and failure of subsequent medication abortion; however, these studies did not isolate method of delivery (Cotte, Monniez, and Norel 2008; Ashok, Templeton, Wagaarachchi, & Flett, 2002; Niinimäki, Martikainen, and Talvensaari-Mattila, 2004; Bartley, Tong, Everington, & Baird, 2000). The sample was 196 women who underwent medication abortion and returned for a two week follow-up appointment at an urban women's health clinic during 2005-2010. The protocol for medication abortion was 200mg Mifepristone orally followed by 400mcg of misoprostol vaginally or buccally administered 12-24 hours later. Failure was defined as positive pregnancy test at follow-up. Demographic and outcome data was collected from patient self-report pre-procedure intake and follow-up questionnaire forms. Parity regardless of delivery type increased the risk of failure (p=0.0422) but previous Cesarean section did not (p = 0.6141). Duration of cramps experienced after Misoprostol insertion were negatively correlated with age (r = -0.25448). A positive correlation was found between longer cramp duration and smoking status. Future studies may benefit from a focus on other outcome measures--such as onset and duration of cramping or bleeding--rather than simply procedure failure or success, and a larger prospective study with formal clinician-guided measure is recommended.
"],"dc:identifier":["https://elischolar.library.yale.edu/ysndt/1007"],"dc:subject":["abortion, Adult Nurse Practitioner, Cesarean section, medication abortion, Women's Health"],"dc:title":["Influence Of Previous Cesarean Section On Clinical Outcome Of Medication Abortion"],"thesis:degree_discipline":["Yale University School of Nursing"],"thesis:degree_level":["Open Access Thesis"],"thesis:degree_name":["Master of Science in Nursing (MSN)"]},"updated_at":"2026-07-24T06:16:00Z"}