Ultrasound to Confirm Gestational Age and Exclude Ectopic Pregnancy

The majority of health care providers who operate in clinics do not have access to ultrasound machines on-site. The mandatory ultrasound requirement therefore requires multiple appointments, likely at different locations. This has the potential to result in serious delays in administering Mifegymiso within the 7-week gestation period, especially in regions where ultrasound services are few and far between, only accessible in hospitals, have long wait lists, etc. In their April 2016 Medical Abortion guidelines, the Journal of Obstetrics and Gynaecology in Canada provided alternative means to confirm gestational age and rule out ectopic pregnancy when ultrasound is not available to the physician. The article notes that “in the absence of readily accessible ultrasound, gestational age can be estimated using last menstrual period (LMP), clinical history, and physical examination, in people who are certain of the date of their LMP. Ultrasound is needed when uncertainty remains.”