Role of routine ultrasonography in monitoring the outcome of medical abortion in a clinical setting

Endometrial thickness following medical abortion is not predictive of subsequent surgical intervention

“…Ultrasonography is commonly performed after medical abortion to confirm expulsion of the gestational sac. As part of the sonographic assessment, endometrial thickness is also often measured and has been described as a tool to guide decision‐making regarding the need for surgical intervention6, 8. Although we found endometrial thickness to be greater in women who subsequently required D&C, our data show that endometrial thickness is not a clinically useful test for predicting this unwanted outcome.…”

“…A variety of endometrial thickness values have been proposed as thresholds to indicate the need for surgical intervention after medical abortion, spontaneous abortion, and vaginal delivery4–6. An endometrial thickness of less than 15 mm has been used to define a completely evacuated uterus after spontaneous abortion and after medical abortion7, 8. In a large prospective study, however, endometrial thickness was not found to be a useful predictor of the subsequent need for D&C following medical management of early pregnancy failure9.…”

“…Two prospective studies found that human chorionic gonadotropin assays performed better than endometrial thickness in predicting the success of medical abortion12, 13. Several studies of ultrasonography after medical abortion have reported descriptive results8, 14. However, the ability of these qualitative descriptions to predict subsequent D&C is difficult to assess.…”

Outcome of first trimester medical termination of pregnancy: definitions and management

“…These two situations may be indistinguishable without histological examination of the tissue (Figures 2 and 3). Therefore, the diagnosis of incomplete abortion should not be based on ultrasound criteria alone but should include hCG testing and/or clinical evaluation [16,28,29]. Also, interventions based on ultrasound diagnosis or a single hCG test alone might be unnecessary.…”

Three‐Dimensional Doppler Sonography in Asymptomatic and Symptomatic Women After Medical Termination of Pregnancy

“…Some authors suggest that sonography could be part of the decision‐making approach to identify women with postprocedure bleeding for surgical intervention 5 . However, the role of sonography as an indication for surgery has recently been questioned, 6 – 9 and its association with bleeding has not been extensively investigated.…”