Satisfactory outcomes after medical abortion without post- procedure ultrasonography

January 01, 0001

Satisfactory outcomes after medical abortion without post- procedure ultrasonography

These US authors conducted a multicenter study with 4,484 women seeking medical abortion at 10 clinics evaluate the ability of women and their providers to assess abortion outcome without the routine use of ultrasonography. Women received the standard medical abortion care with mifepristone-misoprostol in those clinics and blinded clinical assessments before follow-up ultrasonography.

They found: "A total of 3,054 women received medical abortion and had adequate data for evaluation. Twenty women (0.7%) had an ongoing pregnancy. 26 (0.9%) received curettage for retained tissue, empiric treatment for possible infection, or both. 55 (1.8%) received additional uterotonics or other medical abortion-related care. Screening algorithms including patient-observed outcomes, a low-sensitivity pregnancy test, and nonsonographic clinical evaluation were as effective as sonography in identifying women who received interventions at or after the follow-up visit."

The authors concluded: "Relying on women's observations, a low- sensitivity pregnancy test, and clinical examination, women and their providers can accurately assess whether follow-up care is required after medical abortion without routine ultrasonography."

This study provides evidence that routine ultrasonography after medical abortion is unnecessary.

For the full abstract, click here.

Obstetrics & Gynecology 115(2, Part 1):264-272, February 2010
© 2010 The American College of Obstetricians and Gynecologists
Alternatives to a Routine Follow-Up Visit for Early Medical Abortion. Wesley Clark, Hillary Bracken, Jini Tanenhaus, Suzanne Schweikert, E Steve Lichtenberg, Beverly Winikoff. Correspondence to: Dr. Bracken: [email protected]

Category: W. Pregnancy, Childbirth, Family Planning. Keywords: medical abortion, mifepristone, misoprostol, ultrasonography, cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 9 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.