The use of ultrasound is not a requirement for the provision of medication abortion (NAF, SFP, ACOG, ARHP, AAFP, FDA, Ipas, WHO ), and recent trials demonstrate the safety of eliminating routine ultrasound from pre- and post-medication abortion care.
|Ultrasound As-Needed Indications to Inform Clinical Decision-Making (RHEDI)|
The absence of the pregnancy (gestational sac or embryo
depending the US findings prior to MAB) and the presence
of intrauterine debris are typical after successful
medication abortion. The size of the endometrial stripe
has no clinical significance in assessment of success of
a medication abortion, and incorrect interpretation can
lead to unnecessary intervention (SFP 2014).
|PERSISTENT GESTATIONAL SAC
AFTER MEDICATION ABORTION
This transvaginal ultrasound shows the presence of an
empty gestational sac. A persistent gestational sac,
embryo, or fetus indicates an incomplete abortion.
Management options include waiting for spontaneous
completion, administering a repeat dose of misoprostol,
or performing an aspiration procedure.
|Images courtesy of Fjerstad.|