Sonographic patterns of the endometrium in assessment of medical abortion outcomes

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Abstract

Background: We aimed to define endometrial pattern and endometrial thickness in predicting the outcome of early medical abortion. Study Design: While blinded to outcomes of abortion, we retrospectively reviewed the ultrasound scan performed 14-21 days after medical abortion. We assessed the endometrial pattern and endometrial thickness. A total of 943 women at or before 56 days of gestation who underwent medical abortions were included. Abortion was induced with mifepristone (600 mg) orally followed 48 h later with oral misoprostol (600 mcg). A successful medical abortion was defined as complete abortion without surgical intervention. Three sonographic patterns (homogenous, heterogeneous and multilayered) were devised to correlate with the outcome. Results: Of the 940 women, 92 (9.8%) had failed medical abortions. Eighty-seven (94.6%) patients with failed treatment outcomes had a heterogeneous pattern, while no patients with failed treatments had a multilayered pattern. Based on multivariable logistic regression, women who had an endometrial thickness in the range of 10-15 or > 15 mm were more likely to have failed outcomes than those with a thickness <10 mm, with ORs of 3.69 (p=.001) and 8.82 (p 10 mm in combination with a heterogeneous pattern had the highest balanced accuracy in the prediction of failed outcome (81.9%; 95% CI, 77.6-86.3). Conclusion: Women with a multilayered pattern could be reassured that they have successful medical abortion, while those with a heterogeneous pattern and/or endometrium > 10 mm may need follow-up. Sonographic endometrial pattern and endometrial thickness may serve as objective criteria in the management of early medical abortions.

Original languageEnglish
Pages (from-to)153-159
Number of pages7
JournalContraception
Volume88
Issue number1
DOIs
Publication statusPublished - Jul 2013

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Keywords

  • Endometrium
  • Medical abortion
  • Mifepristone
  • Misoprostol
  • Ultrasonography

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

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