Documenting a New World: Research Submitted to the National Abortion Federation's 48th Annual Meeting (May 2–5, 2025, California)
Notice bibliographique
Résumé
Introduction:The reported incidence of breast symptoms after second trimester abortion or miscarriage ranges from 51% to 90%.Symptoms include breast engorgement, pain, and milk leakage.These symptoms can be physically bothersome as well as emotionally distressing.Cabergoline, a dopamine agonist, suppresses lactation, and thus associated symptoms, due to its effect on prolactin.A recent randomized controlled trial demonstrated that cabergoline given postoperatively after dilation and evacuation (D&E) reduced breast symptoms for patients from 18 to 26 weeks' gestation.Data are lacking on cabergoline efficacy and patient acceptance for 14-18 weeks' gestation.Methods: We conducted a prospective cohort study evaluating the practice of routinely offering postoperative cabergoline 1 mg orally to all patients 14-24 weeks gestation undergoing D&E for voluntary termination or fetal demise at an urban academic medical center.We excluded emergent D&Es, current breastfeeding, and uncontrolled hypertension.We collected demographic and clinical characteristics from the electronic medical record.During a postoperative phone call, we administered the Bristol Breast Symptom Inventory, which assesses engorgement, tenderness, leakage and pain relief, defining presence of symptoms as report of at least one inventory symptom.We compared characteristics of patients who took and declined cabergoline using χ 2 and t-tests.We evaluated the association between cabergoline intake and presence of breast symptoms using Fisher's exact test.We stratified the cohort by ethnicity and gestational age < 18 and > 18 weeks and assessed the association between cabergoline intake and breast symptoms using Stata BE18.0 (College Station, TX).Results: Of 144 sequential D&E patients routinely offered cabergoline from January 21, 2023, through October 18, 2024, 93.0% accepted cabergoline.We obtained breast symptom data for 119 (82.6%) patients, a mean 3.5 days postoperatively.Demographic and clinical characteristics were similar between those who took and declined cabergoline except for ethnicity.Patients who took cabergoline were less likely to report presence of breast symptoms compared to those who did not (26.4% versus 75.0%, p = 0.004).Non-Hispanic patients were more likely to decline cabergoline than Hispanic patients (16.4% vs. 0%, p = 0.002) and report breast symptoms (38.4% vs. 22.7%, p = 0.084).Among non-Hispanic patients, the association between cabergoline intake and lower incidence of breast symptoms remained (31.6% vs. 85.7%, p = 0.005).In the overall population, regardless of cabergoline use, there was no association between gestational age and presence of breast symptoms.Among the 44 patients < 18 weeks' gestation, those who took cabergoline were less likely to report breast symptoms than those who did not (16.6% vs. 100%, p = 0.038).There was a trend towards decreased breast symptoms in patients who took cabergoline among the 74 patients > 18 weeks (32.3% vs. 66.7%, p = 0.176).No patients reported negative symptoms that could be attributed to cabergoline intake.Conclusions: Offering cabergoline was feasible and frequently accepted by D&E patients.Cabergoline intake was associated with lower incidence of breast symptoms.Although non-Hispanic patients were more likely to decline cabergoline and had a trend towards reporting increased breast symptoms, the association between cabergoline intake and reduced incidence of breast symptoms remained within this subgroup.Our results are limited by the small number of patients who declined cabergoline.Nevertheless, our findings support the use of cabergoline for lactation-related breast symptoms among D&E patients starting as early as 14 weeks gestation.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,244 | 0,053 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».