P114

ESSURE PROCEDURE: A CASE SERIES IN AN ACADEMICSETTING

Woods SUniversity of New Mexico, Albuquerque, NM, USA

Wintermute R, Ogburn T, Espey E, Singh R, Pereda B

Objectives: To determine the rate of successful completion of Essure coilplacement in a single academic setting. Secondary outcomes includedreasons the procedure was not completed, comparison of success rates in anambulatory surgery center vs. clinic setting, and completion of theconfirmation hysterosalpingogram.Methods: We analyzed a case series of all Essure procedures performedwithin one academic center from January 2005 until January 2012. Caseswere identified using ICD-9 and CPT codes and billing records. Weperformed a retrospective review of the electronic medical record of all theidentified cases. Descriptive statistics were performed. chi-Square wasperformed for comparisons.Results: There were 276 cases identified, 89% of which had successfulbilateral placement of coils on the first attempt. Of the 30 unsuccessfulplacements, the most common reasons were inability to visualize the ostia(14/30) and inability to cannulate the ostia (8/30). Device malfunction wasnoted in two cases. Only 54% of patients completed the follow-uphysterosalpingogram. Ninety-one percent showed bilateral tubal occlusionon the first study. There was no difference between success rates in an officesetting vs. an ambulatory surgery center (p=.45).Conclusions: In a single academic setting, a significant proportion of Essureprocedures are not completed on the first attempt. Success was similar in aclinic setting compared with the OR. Almost half of patients did notcomplete the recommended hysterosalpingogram. Patient counseling shouldaddress the possibility of unsuccessful placement, and systems should bedeveloped to ensure completion of the hysterosalpingogram.

P115

EMERGENCY CONTRACEPTION KNOWLEDGE AMONG U.S.EMERGENCY MEDICINE RESIDENT PHYSICIANS

Chen MNorthwestern University Feinberg School of Medicine, Chicago, IL, USA

Gawron L, Pirotte A, Collings J, York S

Objectives: Emergency medicine (EM) physicians commonly care forwomen at risk of unintended pregnancies, including sexual assault victims.EM resident physicians must be knowledgeable regarding emergencycontraception (EC) to effectively care for these women. This study assessesEC knowledge among EM residents.Methods: An online survey was e-mailed to U.S.-based EM residencyprogram directors for distribution to residents. Current residents who cared forreproductive-aged women were eligible to participate. Fifteen questionsassessed knowledge on EC efficacy, use, mechanism of action and side effects.Results: Three hundred eighty participants accessed the survey, and 345 metinclusion criteria. Mean age was 29.9 years, and 50.3% were female. Alltraining years and U.S. regions were represented. Most participants reportedan academic (74.8%) and non-religious (88.6%) hospital affiliation. Some71.2% reported “always” offering EC following sexual assault, whereas19.5% “always” offered EC after unprotected consensual intercourse; 24.7%had prescribed EC in the last 6 months. Mean knowledge score was 62.2%(SD±9.5%). Most identified the levonorgestrel pill as a form of EC (97.8%);few selected oral contraceptive pills (48.6%), the copper intrauterine device(15.6%) or ulipristal acetate (15.0%). Some 12.5% recognized EC eligibility 4days following a sexual encounter, and 33.6% identified that levonorgestrel

EC works by delaying ovulation, while 31.5% incorrectly stated that ECprevented further embryo development.Conclusions: EM residents often provide care for women at risk ofunintended pregnancy following forced or consensual intercourse, but theylack complete knowledge of EC. There is a need to improve EC educationamong EM residents, potentially increasing EC prescription for womenpresenting to emergency rooms.

P116

CHARACTERISTICS OF YOUNG WOMEN WHODEMONSTRATED CORRECT VERSUS INCORRECT USEOF EMERGENCY CONTRACEPTION

Cwiak CEmory University School of Medicine, Atlanta, GA, USA

Howard B, Hsieh J, Ricciotti N

Objectives: To examine the percentage and characteristics of young womenwho used an emergency contraceptive (EC) correctly versus incorrectly.Methods: This was a post-hoc analysis of an over-the-counter simulationstudy that assessed the ability of young women aged 11–17 to correctly usesingle-dose 1.5 mg levonorgestrel EC. Correct use was defined as use within72 h following unprotected sexual intercourse. Baseline characteristics wereobtained, including age at menarche, age at coitarche, reproductive historyand previous birth control use, if any.Results: Of the 297 young women in the treated population, the majority(88.6%; 263/297) used the EC correctly, whereas 11.4% (34/297) reportedincorrect usage. The average ages of correct and incorrect product users weresimilar (15.7 and 15.5, respectively), as were the average ages at menarche andcoitarche. Use of birth control and types of birth control used were similar:Some 27.8% of correct product users reported having never used birth controlprior to the study, compared with 35.3% of incorrect product users (p=.36).Reproductive histories were similar, with the majority reporting no previouspregnancies, births or abortions (correct users: 88.2%, 97.0% and 92.0%,respectively; incorrect users 85.3%, 97.1% and 91.2%, respectively).Conclusions: Overall, baseline characteristics were very similar betweenyoung women who used EC correctly versus those who used EC incorrectly.Although the majority of young women demonstrated correct EC use, furtherstudies are needed to understand the reasons for incorrect usage in order tobetter serve the contraceptive needs of this population.

P117

MISINFORMATION REGARDING EMERGENCYCONTRACEPTION ON CRISIS PREGNANCY CENTERWEB SITES OF NINE STATES

Narasimhan SUniversity of North Carolina, Chapel Hill, Chapel Hill, NC, USA

Bryant-Comstock K, Bryant A, Levi E

Objectives: To evaluate the accuracy of emergency contraception (EC)information on crisis pregnancy center Web sites.Methods: We conducted a systematic review of the crisis pregnancy centerWeb sites, for women seeking abortion, of nine states. Data regarding ECwas identified through Internet searches of crisis pregnancy center Web sitesthat were listed in the resource directories of state health departments.Results: Web sites for 254 crisis pregnancy centers were identified. A totalof 70 of these sites (28%, 95% CI 10–35%) discuss information on both ECand medical abortion. Fifty sites (20%, 95% CI 5–29%) contained medicallyinaccurate information specifically identifying EC as an abortifacient.Conclusions: Emergency contraception is a safe and effective tool in theprevention of unintended pregnancy. State health department resourcedirectories exist as a trusted resource for women to utilize care. Some crisis

471Abstracts / Contraception 88 (2013) 433–473