Early Abortion and Ectopic Pregnancy

Monday, June 9th, 2014 by Dr Joan F.

If you have done your research, you have probably found that most abortion providers will not offer procedures before 5 weeks, calculated from the first day of your last period. This can be frustrating for some women, as they feel that once they have made the decision to end the pregnancy, they want to do so as quickly as possible.

The reason for needing to wait is that the doctor needs to be able to visualize the pregnancy on an ultrasound to safely move forward with either the Manual Vacuum Aspiration, the Abortion Pill, or a surgical abortion, and usually, this cannot be done until the 6th week. Without being able to clearly identify the pregnancy via ultrasound, they are unable to verify that the pregnancy is developing where it should be, which is inside the uterus. While it is rare, there are situations where the pregnancy will begin to develop in other areas of the body, such at the fallopian tubes. When this occurs, it is known as an ectopic pregnancy, and requires treatment that is not available at our offices.

Statistically, ectopic pregnancies  account for 1-2% off all pregnancies. Because it cannot turn into a normal pregnancy, there is no way to save an ectopic pregnancy. If it continues to develop in the tube, it can damage the tube and cause heavy bleeding that could be very dangerous- sometimes resulting in the need for surgery. That is the reason timely diagnosis and treatment are necessary.

So, you may ask, how would this be diagnosed? The two most common resources used to diagnose ectopic pregnancies are blood tests that check the pregnancy hormone levels in a woman’s body over the course of about 2 days, or a sonogram of the uterus, ovaries, and fallopian tubes.

When a patient comes in and the ultrasound measures less than 6 weeks, there are a few options on how to move forward, which are decided using the doctor’s better judgement based on the patient’s medical history, LMP, and proximity to the office. Sometimes, they are able to move forward with the procedure on the same day, if the patient would like to. They also have the option of rescheduling the appointment for another, later date. If the patient and the doctor decide to complete the procedure the same day, generally we will do a blood pregnancy test that day to measure the hormone levels. This must be followed up with a second blood pregnancy test 2 days later, either in the office or a lab. This allows a comparison of the hormone levels to make sure that they are dropping after the procedure. It can normally be confirmed at that time whether or not the procedure was successful.

In the case that the hormone levels are not dropping, it would be recommend that the patient be seen as soon as possible for testing to check for ectopic pregnancy. Ectopic pregnancy can be very dangerous if not correctly diagnosed or treated.

The simplest and least stressful way to handle this situation is to just wait until 6 weeks to go in for an appointment. When the doctor is able to adequately visualize and measure the pregnancy, they are also able to confirm that same day that the procedure was successful, so the patient is able to leave the office feeling confident that the pregnancy is over.