NEW TECHNOLOGIES PERMIT SAFE ABORTION AT LESS-THAN 6 WEEKS GESTATION AND PROVIDE TIMELY DETECTION OF ECTOPIC GESTATION

OBJECTIVE: The previously held dictum that elective abortion before 6 weeks' gestation carried greater risks than a later procedure was chal lenged by this protocol. STUDY DESIGN: This study evaluated a protocol for abortion before the customary 6 weeks' gestation. Patients willin g to return to the clinic within 72 hours were given the option of ele ctive abortion even when no gesiational sac could be visualized with t ransvaginal ultrasonography. When no chorionic membrane with villi was seen in the curettings, postoperative serum levels of beta-human chor ionic gonadotropin confirmed complete evacuation or diagnosed ectopic pregnancy. RESULTS: In 1530 abortion procedures at <6 weeks' gestation by ultrasonographic criteria no serious complications occurred. In ad dition, 9 (0.67%) unsuspected ectopic pregnancies were diagnosed. CONC LUSIONS: Abortion before 6 weeks' gestation is safe, given close surve illance. Early termination combined with vaginal ultrasonography and f ollow-up with beta-human chorionic gonadotropin measurements allows di agnosis of early, unsuspected ectopic pregnancy. Ectopic pregnancy was found to be uncommon in women requesting early abortion.