[Very early medical abortion, a termination of pregnancy before ultrasound evidence: something to aim for in the Netherlands?].

OBJECTIVE

A very early medical abortion (VEMA) is an abortion early in pregnancy before the pregnancy is visible on an ultrasound. This treatment has been offered in several countries for many years. Our objective was to investigate whether VEMA is also desirable and can be carried out safely, in the Netherlands.

DESIGN

Descriptive study.

METHOD: From August 2019 to February 2020 VEMA was offered to women who met the inclusion criteria. A fixed protocol for diagnostic examinations and follow up was used. Ultrasounds and serial human chorionic gonadotrophin assays were used to ensure safety and effectiveness. Satisfaction survey was conducted among clients and employees. The costs of different treatments, including VEMA, were compared.

RESULTS

During the study period 693 women received an abortion treatment in our clinic. 69 women met the inclusion criteria for VEMA. Three of them were referred to the local hospital because of an (suspected) ectopic pregnancy. No ectopic pregnancy was missed later in the process. VEMA was effective in 64 women. Two women needed a second treatment. Eight women did not appear for follow-up without an extra reminder. Women and healthcare providers were very satisfied with the offer of VEMA. VEMA was more expensive than other forms of treatment.

CONCLUSION

Our study showed that very early medical abortion is safe and achievable in the Netherlands and highly appreciated. When introducing this treatment, a strict protocol is necessary. We advise to offer this treatment to women who prefer a very early abortion.