{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T21:08:17Z","timestamp":1790024897752,"version":"4.0.1"},"reference-count":17,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/N022556\/1"],"award-info":[{"award-number":["MR\/N022556\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2020,12,7]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Routine ultrasound may be used in abortion services to determine gestational age and confirm an intrauterine pregnancy. However, ultrasound adds complexity to care and results may be inconclusive, delaying abortion. We sought to determine the rate of ectopic pregnancy and the utility of routine ultrasound in its detection, in a community abortion service.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective case record review of women requesting abortion over a 5-year period (2015\u20132019) with an outcome of ectopic pregnancy or pregnancy of unknown location (PUL) at a service (Edinburgh, UK) conducting routine ultrasound on all women. Records were searched for symptoms at presentation, development of symptoms during clinical care, significant risk factors and routine ultrasound findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Only 29\/11\u2009381 women (0.25%, 95%\u2009CI 0.18%, 0.33%) had an ectopic pregnancy or PUL (tubal=18, caesarean scar=1, heterotopic=1, PUL=9). Eleven (38%) cases had either symptoms at presentation (n=8) and\/or significant risk factors for ectopic pregnancy (n=4). A further 12 women developed symptoms during their clinical care. Of the remaining six, three were PUL treated with methotrexate and three were ectopic (salpingectomy=2, methotrexate=1). In three cases, the baseline ultrasound indicated a probable early intrauterine pregnancy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Ectopic pregnancies are uncommon among women presenting for abortion. The value of routine ultrasound in excluding ectopic pregnancy in symptom-free women without significant risk factors is questionable as it may aid detection of some cases but may provide false reassurance that a pregnancy is intrauterine.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2020-200888","type":"journal-article","created":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T13:20:55Z","timestamp":1609248055000},"page":"22-27","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Utility of a routine ultrasound for detection of ectopic pregnancies among women requesting abortion: a retrospective review"],"prefix":"10.1136","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3873-6243","authenticated-orcid":false,"given":"Clara I","family":"Duncan","sequence":"first","affiliation":[{"name":"The Medical School, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6597-1666","authenticated-orcid":false,"given":"John J","family":"Reynolds-Wright","sequence":"additional","affiliation":[{"name":"Queen's Medical Research Institute, MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK"},{"name":"NHS Lothian, Chalmers Centre, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1168-2276","authenticated-orcid":false,"given":"Sharon T","family":"Cameron","sequence":"additional","affiliation":[{"name":"Queen's Medical Research Institute, MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK"},{"name":"NHS Lothian, Chalmers Centre, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,29]]},"reference":[{"key":"2025090512025807000_48.1.22.1","unstructured":"Royal College of Obstetricians & Gynaecologists . The care of women requesting induced abortion (Evidence-based Clinical Guideline No. 7). Available: https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/the-care-of-women-requesting-induced-abortion\/ [Accessed 10 Mar 2020]."},{"key":"2025090512025807000_48.1.22.2","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.contraception.2010.07.023","article-title":"Expanding medical abortion: can medical abortion be effectively provided without the routine use of ultrasound?","volume":"83","author":"Kaneshiro","year":"2011","journal-title":"Contraception"},{"key":"2025090512025807000_48.1.22.3","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2014-100924"},{"key":"2025090512025807000_48.1.22.4","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dep084"},{"key":"2025090512025807000_48.1.22.5","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1111\/1471-0528.14904","article-title":"Efficacy and safety of very early medical termination of pregnancy: a cohort study","volume":"124","author":"Bizjak","year":"2017","journal-title":"BJOG"},{"key":"2025090512025807000_48.1.22.6","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1111\/aogs.13797","article-title":"Initiation of abortion before there is definitive ultrasound evidence of intrauterine pregnancy: a systematic review with meta-analyses","volume":"99","author":"Schmidt-Hansen","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025090512025807000_48.1.22.7","unstructured":"National Institute for Health and Care Excellence (NICE) . Abortion care. NICE guideline [NG140], 2019. Available: https:\/\/www.nice.org.uk\/guidance\/ng140 [Accessed 3 Nov 2020]."},{"key":"2025090512025807000_48.1.22.8","unstructured":"Royal College of Obstetricians & Gynaecologists . Diagnosis and management of ectopic pregnancy. Available: https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/gtg21\/ [Accessed 31 Aug 2019]."},{"key":"2025090512025807000_48.1.22.9","doi-asserted-by":"publisher","DOI":"10.1136\/ewjm.173.2.131"},{"key":"2025090512025807000_48.1.22.10","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/AOG.0b013e3182755763","article-title":"Significant adverse events and outcomes after medical abortion","volume":"121","author":"Cleland","year":"2013","journal-title":"Obstet Gynecol"},{"key":"2025090512025807000_48.1.22.11","unstructured":"Royal College of Obstetricians & Gynaecologists . Coronavirus (COVID-19) infection and abortion care. Available: https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/coronavirus-abortion\/ [Accessed 15 Jul 2020]."},{"key":"2025090512025807000_48.1.22.12","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2018-200264"},{"key":"2025090512025807000_48.1.22.13","unstructured":"Department of Health . Caldicott Priniciples. Information governance toolkit. Available: https:\/\/www.igt.hscic.gov.uk\/Caldicott2Principles.aspx [Accessed 10 Mar 2020]."},{"key":"2025090512025807000_48.1.22.14","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000130839.61098.12"},{"key":"2025090512025807000_48.1.22.15","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15255"},{"key":"2025090512025807000_48.1.22.16","unstructured":"National Institute for Health and Care Excellence (NICE) . Ectopic pregnancy and miscarriage: diagnosis and initial management. NICE guideline [NG126], 2019. Available: https:\/\/www.nice.org.uk\/guidance\/ng126\/chapter\/Recommendations#expectant-management-2 [Accessed 17 Sep 2020]."},{"key":"2025090512025807000_48.1.22.17","unstructured":"GOV.UK . Abortion statistics for England and Wales during the COVID-19 pandemic, 2020. Available: https:\/\/www.gov.uk\/government\/publications\/abortion-statistics-during-the-coronavirus-pandemic-january-to-june-2020\/abortion-statistics-for-england-and-wales-during-the-covid-19-pandemic"}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2020-200888","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:09:47Z","timestamp":1757099387000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2020-200888"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,29]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,10]]},"published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1136\/bmjsrh-2020-200888"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2020-200888","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,29]]}}}