Updated screening protocol for abortion services

We performed 2976 first-trimester abortions at our outpatient center in 1986. In 16 cases (0.54%), products of conception could not be confirmed histologically, although history, bimanual pelvic examination, and urine pregnancy test were suggestive of pregnancy. In 1987-1988, we prospectively evaluated 6689 women presenting for first-trimester abortions. Adding sonography and a semiquantitative serum hCG test to our earlier protocol, we were able to date and locate accurately 6510 pregnancies (97.3%) at the first visit. The remaining 179 patients (2.7%) required only one follow-up visit for final evaluation. This protocol reduced the number of visits for accurate evaluation of pregnancy and eliminated the risk of unnecessary curettage and unplanned second-trimester abortions.