3. PRE-ABORTION EVALUATION

Updated June 2020, by Montida Fleming MD and Caitlin Weber MD, MS

This chapter will address history, physical exam, and testing prior to abortion to ensure that a patient is eligible for a procedure and the chosen method is safe. The pre-abortion evaluation is focused on pregnancy dating and pertinent medical history. Pregnancy dating is usually done by asking a patient their last menstrual period (LMP); Depending on setting, this can be done with addition of bimanual exam, and if needed, with diagnostic ultrasound (US). Although persons of childbearing age are typically healthy and eligible for outpatient abortion, this chapter will address when referral is necessary for safety.

CHAPTER LEARNING OBJECTIVES

Following completion of this chapter, you should be better able to:

  • Use clinical findings to confirm intrauterine pregnancy and accurately date pregnancy
  • Gather appropriate historical, physical exam, and lab information as needed to safely perform uterine aspiration or medication abortion in an outpatient setting, and know when to consult/refer
  • Use sonographic findings to diagnose intrauterine pregnancy or early pregnancy loss
  • List clinical, lab, and sonographic findings that constitute red flags for ectopic pregnancy

READINGS / RESOURCES

  • Ultrasound Lecture Series: Obstetrics and Gynecology, AUIM 2013
    • https://www.aium.org/uls/lectures.htm
  • Paul et al (eds). Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care (Wiley-Blackwell, 2009)
    • Chapter 6: Clinical Assessment and Ultrasound in Early Pregnancy
    • Chapter 7: Medical Evaluation and Management

VIDEOS

 

License

EARLY ABORTION TRAINING CURRICULUM Copyright © 2020 by UCSF Bixby Center for Global Reproductive Health. All Rights Reserved.