Completion of medication abortion (MA) must be assessed by the provider. Depending on the circumstances, this can be done by obtaining a clinical history, ultrasonography, or urine or serum bhCG testing. This assessment can be done in person, by telephone or electronic communication as per clinical indication and the preferences of the patient and the provider.

Clinical history[6]: The assessment of successful expulsion based on medical history is highly predictive of complete abortion (sensitivity 99.1%, specificity 45.5%). No bleeding or minimal bleeding after MISO, and continuing pregnancy symptoms are suggestive of an ongoing pregnancy.

Urine bhCG[7]:

Serum bhCG[3]:

• A drop by at least 50% from baseline at 3 days after MIFE administration (or 24 and 48 hours after MISO administration) is highly indicative of complete abortion.
• A drop by 80% between 7 and 14 days after MIFE / MISO administration confirms abortion completion.
• If bhCG drops < 80% between day 7 and 14, prescribers may order an ultrasound or repeat the test in a few days. Ultrasound should be ordered if 14 days have passed and a drop by 80% has not been reached.

Ultrasonography[6]: Ultrasound provides definitive evidence of MA completion, but no evidence shows that it is superior to other methods. It is recommended in cases where the outcome is uncertain based on clinical history, or there are symptoms such as unexpected pain, prolonged heavy bleeding or inadequate bleeding.