Expanding medical abortion: Can medical abortion be effectively provided without the routine use of ultrasound?

Bliss Kaneshiro, Alison Edelman, Robyn K. Sneeringer, Rodolfo Gomez Ponce De Leon

Research output: Contribution to journalReview article

12 Scopus citations

Abstract

Medical abortion studies have traditionally relied on ultrasound to confirm gestational age, intrauterine location and abortion completion. However, the routine dependence on ultrasound can limit access to safe services for women living in low resource settings that are often most in need of safe abortion care. This review discusses the literature surrounding the safe provision of medical abortion without the routine use of ultrasonography and concludes that clinicians can use the reported last menstrual period (LMP) and physical examination to reasonably estimate gestational age. Completed pregnancy expulsion can be confirmed primarily through history and physical examination with some studies indicating that urine pregnancy tests may also play a limited role. Central to the discussion of whether medical abortion can be provided in most low resource settings without the routine use of ultrasonography is the fact that the mifepristone-misoprostol regimen is a highly effective procedure for pregnancy termination through 63 days' gestation.

Original languageEnglish (US)
Pages (from-to)194-201
Number of pages8
JournalContraception
Volume83
Issue number3
DOIs
StatePublished - Mar 2011

Keywords

  • Abortion
  • Gestational age dating
  • Medical abortion
  • Pregnancy termination
  • Ultrasound

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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