Routine Pathology for Intrauterine Devices and Therapeutic Abortion: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

/

Ron Pohar, Kelly Farrah

Canadian Agency for Drugs and Technologies in Health

September 12, 2019

No conclusions can be made regarding the clinical utility of routine pathology for removed intrauterine devices or cost-effectiveness of routine pathology for therapeutic abortion or removed intrauterine devices, due to the lack of literature identified for these questions. No guidelines regarding routine pathology for removed intrauterine devices were identified. As such, no conclusion can be made.

Canadian Agency for Drugs and Technologies in Health

CADTH is an independent, not-for-profit organization responsible for providing health care decision-makers with objective evidence to help make informed decisions about the optimal use of health technologies

References

1.Damjanov I, Vranic S, Skenderi F. Does everything a surgeon takes out have to be seen by a pathologist? A review of the current pathology practice. Virchows Arch. 2016;468(1):69–74. [PubMed]

2.Hsia JK, Creinin MD. Intrauterine contraception. Semin Reprod Med. 2016;34(03):175–182. [PubMed]

3.Rayani R, McInnes K. Hormonal and IUD contraceptive agents available in Canada. Vancouver (BC): British Columbia Drug and Poison Information Centre; 2017: http://www​.dpic.org/article​/professional​/hormonal-and-iud-contraceptive-agents-available-canada. Accessed 2019 Sep 9.

4.Ernst LM, Gawron L, Fritsch MK. Pathologic examination of fetal and placental tissue obtained by dilation and evacuation. Arch Pathol Lab Med. 2013;137(3):326–337. [PubMed]

5.Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–536. [PubMed]

6.Agree Next Steps Consortium. The AGREE II Instrument. [Hamilton, ON]: AGREE Enterprise; 2017: https://www​.agreetrust​.org/wp-content/uploads​/2017/12/AGREE-II-Users-Manual-and-23-item-Instrument-2009-Update-2017.pdf. Accessed 2019 Sep 9.

7.Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–e34. [PubMed]

8.Paul M, Lackie E, Mitchell C, Rogers A, Fox M. Is pathology examination useful after early surgical abortion? Obstet Gynecol. 2002;99(4):567–571. [PubMed]

9.National Abortion Federation. Clinical policy guidelines for abortion care. Washington (DC): NAF; 2018: https:​//5aa1b2xfmfh2e2mk03kk8rsx-wpengine​.netdna-ssl.com/wp-content​/uploads/2018_CPGs.pdf. Accessed 2019 Sep 9.

10.Costescu D, Guilbert E. No. 360-Induced abortion: surgical abortion and second trimester medical methods [Society of Obstetricians and Gynaecologists of Canada (SOGC) Clinical Practice Guideline]. J Obstet Gynaecol Can. 2018;40(6):750–783. [PubMed]

11.National Abortion Federation Canada. Abortion coverage by region. http://www​.nafcanada​.org/access-region.html. Accessed 2019 Sep 9.