Documenting a New World: Research Submitted to the National Abortion Federation's 48th Annual Meeting (May 2–5, 2025, California)
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.244 | 0.053 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".