{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:41:33Z","timestamp":1787568093663,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Australia, ultrasonography to confirm gestational age (GA) and pregnancy location is a routine component of early medical abortion (EMA) care. Internationally, protocols have been developed using a history\u2010based screening tool to identify women not requiring ultrasound. This approach, now supported by Australian guidelines, aims to reduce unnecessary barriers to abortion care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the validity and accuracy of an eligibility assessment tool for no\u2010ultrasound EMA care. Self\u2010reported estimation of GA and risk factors for ectopic pregnancy were compared to ultrasound findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This was a multicentre prospective observational study. Patients aged 14\u2009years and over attending for EMA completed a questionnaire, including estimation of GA using last menstrual period (LMP) or date of conception (DOC), if known, and identification of risk factors for ectopic pregnancy. All patients subsequently underwent routine abortion care, including ultrasound assessment, and outcomes were determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 705 patients who completed the questionnaire between 4 January 2022 and 30 August 2023, 469 were certain of their LMP or DOC (66.5%). When the screening tool was applied, 214 (30.4%) patients remained eligible for no\u2010ultrasound care, and all these were found to have an intrauterine pregnancy. One patient had a GA over 63\u2009days by ultrasound.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A history\u2010based screening tool determined 30% of patients eligible for no\u2010ultrasound EMA care. No eligible patients had an ectopic pregnancy and only one had an ultrasound confirmed GA above 63\u2009days. Models of EMA care not requiring routine ultrasound may improve abortion access, especially for those in rural and remote areas where ultrasound availability can be challenging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.70148","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T20:11:24Z","timestamp":1782936684000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determining the Feasibility of a No\u2010Ultrasound Screening Tool for Early Medical Abortion in Australia"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5891-0259","authenticated-orcid":false,"given":"Catriona","family":"Melville","sequence":"first","affiliation":[{"name":"MSI Australia  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Goldstone","sequence":"additional","affiliation":[{"name":"MSI Australia  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2017.11.005"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16668"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2020.04.005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02753.x"},{"key":"e_1_2_8_6_1","unstructured":"MS Health \u201cAustralian Product Information MS 2\u2010Step (Mifepristone and Misoprostol) Tablets \u201d2024 accessed 23 March 2025 Australian Product Information MS\u20102 Step TGA."},{"key":"e_1_2_8_7_1","unstructured":"Royal Australian and New Zealand College of Obstetricians and Gynaecologists \u201cClinical Guideline for Abortion Care: An Evidence\u2010Based Guideline on Abortion Care in Australia and Aotearoa New Zealand (2023) \u201d2023 accessed 23 March 2025 https:\/\/ranzcog.edu.au\/wp\u2010content\/uploads\/Clinical\u2010Guideline\u2010Abortion\u2010Care.pdf."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2020-200888"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.07.023"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753\u20106405.12641"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1363\/46e2414"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2023.2249158"},{"key":"e_1_2_8_13_1","volume-title":"New Zealand Aotearoa Abortion Clinical Guideline","author":"Ministry of Health (New Zealand)","year":"2021"},{"key":"e_1_2_8_14_1","unstructured":"National Institute for Health and Care Excellence (NICE) 2019 zLondon accessed 23 March 2025 www.nice.org.uk\/guidance\/ng140."},{"key":"e_1_2_8_15_1","unstructured":"Royal College of Obstetricians and Gynaecologists \u201cCoronavirus (COVID\u201019) Infection and Abortion Care \u201d2020 accessed 23 March 2025 https:\/\/www.rcog.org.uk\/guidance\/coronavirus\u2010covid\u201019\u2010pregnancy\u2010and\u2010women\u2010s\u2010health\/coronavirus\u2010covid\u201019\u2010infection\u2010and\u2010abortion\u2010care\/."},{"key":"e_1_2_8_16_1","unstructured":"American College of Obstetricians and Gynecologists \u201cMedication Abortion up to 70\u2009Days of Gestation \u201d2020 accessed 23 March 2025 https:\/\/www.acog.org\/clinical\/clinical\u2010guidance\/practice\u2010bulletin\/articles\/2020\/10\/medication\u2010abortion\u2010up\u2010to\u201070\u2010days\u2010of\u2010gestation."},{"key":"e_1_2_8_17_1","unstructured":"National Abortion Federation \u201cClinical Policy Guidelines for Abortion Care \u201d2024 accessed 23 March 2025 https:\/\/prochoice.org\/wp\u2010content\/uploads\/2024\u2010CPGs\u2010FINAL\u20101.pdf."},{"key":"e_1_2_8_18_1","unstructured":"World Health Organization \u201cAbortion Care Guideline \u201d2012 accessed 23 March 2025 https:\/\/www.who.int\/publications\/i\/item\/9789240039483."},{"key":"e_1_2_8_19_1","unstructured":"Royal College of Obstetricians and Gynaecologists (RCOG) \u201cDecision Aid for Early Medical Abortion Without Ultrasound \u201d2020 London: Royal College of Obstetricians and Gynaecologists (RCOG). 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