Verifying the effectiveness of medical abortion; ultrasound versus hCG testing

Eur J Obstet Gynecol Reprod Biol. 2003 Aug 15;109(2):190-5. doi: 10.1016/s0301-2115(03)00012-5.


Objectives: The combination of mifepristone and misoprostol is an established method for termination of pregnancy. However, there is no general agreement about how best to evaluate the treatment outcome.

Study design: In 217 women with an unwanted pregnancy below 49 days of amenorrhoea, ultrasound examination and serum hCG test were performed before treatment and at follow-up.

Results: Treatment was successful in 98.2%. At follow-up their hCG dropped to a mean of 3% (S.D. 3) of initial levels and the endometrium measured a mean of 10 mm (S.D. 4). Interpretation of endometrium was difficult in some cases because of inhomogeneous structure. Using hCG was reliable in 98.5% of successful abortions. For ultrasound the corresponding figure was 89.8% for the cases with a confirmed intrauterine pregnancy before treatment but only 66% if all pregnancies were included.

Conclusion: Measuring serum hCG before treatment and at follow-up is more effective than ultrasound to confirm a successful medically induced abortion in early pregnancy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortifacient Agents / therapeutic use*
  • Abortion, Induced / methods*
  • Chorionic Gonadotropin / blood*
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Mifepristone / therapeutic use*
  • Misoprostol / therapeutic use*
  • Pregnancy
  • Pregnancy Trimester, First / blood
  • Treatment Outcome
  • Ultrasonography
  • Uterus / diagnostic imaging*


  • Abortifacient Agents
  • Chorionic Gonadotropin
  • Misoprostol
  • Mifepristone