Patients no longer need to wait until they are 6 wks LMP to have an abortion. EVA can be performed as early as 3 weeks from the last menstrual period (LMP).
Patient can undergo an EVA even prior to missing her menses, provided that the positive pregnancy test result is confirmed .
Patient can undergo EVA even if the pregnancy is not detectable
by ultrasound. Ultrasound is not as sensitive as a pregnancy test. A positive pregnancy test can be present with either a normal uterine pregnancy, a recent miscarriage, an induced abortion, or with an ectopic pregnancy.
EVA basically is a mini- suction curettage or "menstrual extraction" which requires to use smaller and fewer instruments that the suction curettage performed at 7 or more weeks LMP.
Compared to suction curettage the EVA has the following advantages:
a) usually there is minimal pain and discomfort when EVA is performed early in pregnancy because of the small amount of cervical dilation and lesser time that are required. Patient may return to normal activities the next day.
b) Some women feel better knowing that an early pregnancy is significantly less formed. The size of an embryo at 5 wks LMP is only 1mm, about the size of a grain of sand; and at 6 wks LMP, its size is only 4 mm, about the size of a small grain of rice.
c) Experiencing no delay helps decrease anxiety, vomiting and other symptoms of pregnancy. Having the tissue aspirate available for examination means patients can be sure of the result immediately, which is usually the case when the ultrasound had showed a gestational sac that is consistent with uterine pregnancy.
d) EVA may proactively search for a possible ectopic pregnancy when a pregnancy is not detected by ultrasound, which makes uncertain the location of the pregnancy. A timely diagnosis of ectopic pregnancy makes it possible to treat an ectopic pregnancy with medications instead of surgery. Emergency surgery and blood transfusions are avoided and hospital care is not needed, all of which represent significant savings to the patient.
The diagnosis of un-ruptured ectopic may be done in the office, without laparoscopy, and its non-surgical medication treatment may start three or four days following an EVA.
A blood pregnancy test (called “serum quantitative hCG” or “hCG titer”) may be performed on the day of the procedure (which is the baseline hCG or hCG titer #1); and a repeat test is obtained in 24 or 48 hours (which is hCG titer #2).
A decline of at least 20% in the hCG titer #2 confirms the success of the abortion and also rules out the possibility of an ectopic (extra-uterine) pregnancy.
If hCG titer #2 is higher than the baseline titer #1 hCG means that the patient has an ongoing pregnancy which may be either an ectopic pregnancy or a failed abortion.
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If you have any questions or would like more information, please contact All Women's Clinic at the following numbers:
Toll Free: (800) 867-1693 Local calls: (954) 772-HELP (4357) or (954) 772-0933
You also may text your questions to: (954) 805-5821
Our address is 2100 E Commercial Blvd, Fort Lauderdale, Florida 33308-3822
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