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Routine ultrasound before medication abortion may create an impediment to expanding abortion access. This study examines clinical outcomes among medication abortion patients without pretreatment ultrasound evaluation at Planned Parenthood health centers in multiple states.
We conducted a secondary analysis among 23 Planned Parenthood affiliates that provided medication abortion without pretreatment ultrasound for eligible patients from March 2020 to December 2021. Affiliates collected and aggregated electronic health record data from 19,041 medication abortion patients at <=77 days’ gestation (based on self-report of last menstrual period) without a pretreatment ultrasound. Among patients with follow up (n=10,085, 53%), we calculated the incidence rates and 95% CI of the following outcomes: completed abortion, ongoing pregnancy, surgical intervention, emergency department and hospital admissions associated with medication abortion, and confirmed ectopic pregnancies.
Among medication abortion patients with follow-up, 96.6% had a complete abortion (95% CI, 96.3–97.0%), and 2.0% had an ongoing pregnancy (95% CI, 1.7%–2.3%). Four percent of medication abortion patients had a subsequent surgical procedure (4.0%, 95% CI, 3.6%–4.4%), and 2.3% had a documented emergency department/hospital admission (95% CI, 2.0%–2.6%). About 2 in 1,000 had a confirmed ectopic pregnancy (1.7, 95% CI, 1.0–2.7 per 1,000).
Our calculated incidence rates of clinical outcomes align with rates from the previous literature on medication abortion with pretreatment ultrasonography and from the emerging literature on medication abortion without pretreatment ultrasonography. Findings from this analysis suggest that medication abortion without pretreatment ultrasound is safe and effective for eligible patients.
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© 2022 Published by Elsevier Inc.