This study was designed to demonstrate the safety and efficacy of providing medication abortion in a primary care site without routine use of pre- and postprocedure transvaginal sonography.
We performed a retrospective record review of 172 consecutive patients choosing medication abortion at our clinic. Our protocol used sonography only as needed for specific indications. All patients were intended to be followed up with serum human chorionic gonadotropin (hCG) testing pre- and posttreatment.
Of the 151 patients not lost to follow-up, 96 (63%) had pretreatment sonography according to protocol or physician preference and 55 did not. Ninety-nine percent (95/96) of those receiving initial sonography had a successful, and uneventful, medication abortion treatment, while 98.2% (54/55) of those not receiving an initial sonography did so. This difference was not statistically significant (.597 by one-sided Fisher's Exact Test). All 119 of the women who did not receive postabortion sonography aborted completely. Only 4 of the 91 women who had both pre- and postprocedure hCG measurements, all of whom aborted successfully, had follow-up-to-initial hCG ratios of greater than 0.2 (20%).
Using a clinical protocol that involves obtaining pre- and posttreatment serum hCG measurements, with sonograms only when indicated, has similar outcomes to a protocol that uses mandatory pre- and posttreatment sonograms.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Contraception
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Mifepristone���misoprostol medical abortion: who will use it and why?.Am Obstet Gynecol. 1998; 179: 1376
- Mifepristone in the United States: status and future.in: The Guttmacher report on public policy. 2002: 4-7
- Clinicians' perception of sonogram indication for mifepristone abortion up to 63 days.Contraception. 2002; 66: 27-31
- Abortion with mifepristone and misoprostol: regimens, efficacy, acceptability and future directions.Am J Obstet Gynecol. 2000; 183: S44-S53
- The roles of clinical assessment, human chorionic gonadotropin assays and ultrasonography in medical abortion practice.Am Obstet Gynecol. 2000; 183: S34-S43
- Predicting delivery date by ultrasound and last menstrual period in early gestation.Obstet Gynecol. 2001; 97: 189-194
- Routine ultrasound for pregnancy termination requests increases women's choice and reduces inappropriate treatments.Br J Obstet Gynecol. 2004; 111: 79-82
- Determination of gestational age by serum concentrations of human chorionic gonadotropin.Obstet Gynecol. 1983; 62: 37-40
- Change in serum beta-human chorionic gonadotropin after abortion with methotrexate and misoprostol.Am Obstet Gynecol. 1996; 174: 776-778
- Monitoring serum chorionic gonadotropin levels after mifepristone abortion.Contraception. 2001; 64: 271-273
- Verifying the effectiveness of medical abortion: ultrasound versus hCG testing.Eur Obstet Gynecol Reprod Biol. 2003; 109: 190-195
Published online: December 27, 2006
Accepted: August 2, 2006
Received in revised form: July 27, 2006
Received: September 7, 2005
���There was no funding for this study.
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.