From the Research
After a medical abortion, OB-GYN guidelines recommend follow-up hCG monitoring to ensure complete pregnancy termination and to detect potential complications like gestational trophoblastic disease (molar pregnancy), as outlined in the most recent study 1. The purpose of this monitoring is to identify any potential issues that may have arisen during the abortion process. Key aspects of post-medical abortion care include:
- Serial quantitative hCG blood tests until levels return to non-pregnant range, typically at 2-week intervals, as this is crucial for detecting any complications early on 2.
- A plateau or rise in hCG levels after initial decline warrants immediate medical evaluation, as this could indicate the presence of abnormal tissue 3.
- Reliable contraception should be used for at least 6 months following treatment, with hormonal methods being acceptable options, to prevent any further unintended pregnancies 1.
- Patients should report any abnormal bleeding, severe pelvic pain, or fever promptly, as these could be signs of complications 4. These measures are important because molar pregnancies involve abnormal placental tissue growth that can persist after abortion and potentially become malignant if not detected early. While molar pregnancies are not caused by chemical abortions, the monitoring protocol helps identify cases where abnormal tissue might have been present but not initially detected. Regular follow-up appointments are essential to ensure complete resolution and to monitor for any complications, as emphasized in the study 1. It is also important to note that the safety and efficacy of medical abortion in the second trimester is provider independent and may offer advantages over surgical second trimester abortion in certain settings, as discussed in the study 1. However, the optimal dosing of prostaglandin to achieve the highest efficacy with the lowest proportion of complications remains to be established, and complications such as uterine rupture can occur, especially in women with a previous cesarean delivery or uterine surgery 1. Overall, the guidelines emphasize the importance of careful monitoring and follow-up care after a medical abortion to ensure the best possible outcomes for patients.