title: What is the right timing for ultrasound evaluation after pregnancy termination with mifepristone?
abstract: OBJECTIVE
  To determine the timing for ultrasound evaluation after medical termination of pregnancy (MTOP).
  
  
  METHODS
  The records of 301 consecutive women who underwent MTOP between July 2010 and July 2011 were studied retrospectively. The follow-up protocol included ultrasound evaluation 2 weeks after MTOP. Surgical termination was offered when pregnancy was found to be ongoing, and either hysteroscopy/curettage or a repeat ultrasound 2 weeks later was offered when the ultrasound findings were suspicious for retained products of conception. Pathology reports were used to confirm the presence of retained products of conception.
  
  
  RESULTS
  Women with ultrasound findings suspicious for retained products of conception were significantly older than women with negative ultrasound findings (30.9±7.7 years vs 24.8±6 years, p<0.0001). Two weeks after MTOP, ultrasound findings were negative in 236 women and suspicious in 66 women. This rate declined as the interval between ultrasound evaluation and MTOP increased (up to 10 weeks). Of the 18 women (5.98%) who underwent hysteroscopy/curettage, pathology reports indicated that 15 (83.3%) had true residua.
  
  
  CONCLUSIONS
  At 2 weeks after MTOP, ultrasound findings suspicious for retained products of conception do not conclusively indicate failure of the procedure. Ultrasound evaluation should be repeated 4-6 weeks later (6-8 weeks after MTOP) in women with suspected residua before diagnosing failure of the procedure.
authors.affiliation: Department of Obstetrics and Gynaecology, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: J
authors.initials: J
authors.lastname: Amer-Alshiek
authors.affiliation: Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
authors.forename: O
authors.initials: O
authors.lastname: Shiekh
authors.affiliation: Department of Obstetrics and Gynaecology, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Agmon
authors.affiliation: Department of Obstetrics and Gynaecology, Tel Aviv Sourasky Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: grisaro@post.tau.ac.il.
authors.forename: D
authors.initials: D
authors.lastname: Grisaru
mesh_terms: D000021:Abortifacient Agents, Steroidal; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D015735:Mifepristone; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D000021:Abortifacient Agents, Steroidal; D015735:Mifepristone
keywords: Failure; Hysteroscopy; Medical termination of pregnancy; Ultrasound