Module 4: Point of care ultrasound in first trimester abortion (POCUS)
The World Health Organization (WHO) outlines that ultrasound is not necessary to provide abortion care, but it is a simple diagnostic tool that can provide useful information. Ultrasound, not urine βhCG or blood tests, is the fastest way to determine a viable pregnancy.
1. Ultrasound can be used to diagnose the location of the pregnancy and ectopic pregnancies
An ectopic pregnancy occurs when the fertilised egg implants somewhere other than the uterus. In an ectopic pregnancy, the egg most often implants in the fallopian tube (a tubal pregnancy), but it can also implant inside the ovary, in the abdominal cavity or on the cervix. Continuing the pregnancy could destroy an ovary or a fallopian tube and cause life-threatening blood loss for the mother.
If a patient were to have an ectopic pregnancy and follow through with an abortion procedure, the treatment would not have any effect on it and the pregnancy would continue to grow and cause serious risks.
See the relevant research into this in the Background Information section.
As a consequence of this research and associated guidelines, it is evident that handheld ultrasound has an excellent prediction confirming viable IUP from gestational week 7, but an ectopic risk assessment should be completed and gestation estimated through LMP and physical examination, rather than relying on these simple handheld ultrasound tools to provide this diagnosis.
2. Ultrasounds can determine gestational age.
It is very important to know the gestation of a pregnancy before an abortion is performed and an indication of gestation can be achieved using this simple diagnostic tool.
3. Ultrasounds help the patient to be fully informed.
The patient should be fully informed before making any decision. Having an ultrasound will help them to make a fully informed choice.