Prescribers will provide clinical assessments prior to prescribing MIFE / MISO. With the new guideline by SOGC for the provision of medical abortion via telemedicine (MA), prescribers may eliminate blood work or ultrasound, or both, to ensure timely provision of MA[7]
- Gestational age is determined using medical history, urine or serum βhCG test, or ultrasound. Ultrasound is not required to determine gestational age, unless people seeking abortion are uncertain of their last menstrual period[6,7].
- Ectopic pregnancy is ruled out using medical history to screen for risk factors and symptoms. Ultrasound is recommended if there are significant risk factors or symptoms suggestive of ectopic pregnancy[6,7].
- Guideline on Rhesus testing and administration varies:
- SOGC’s Guideline on Prevention of RhD Alloimmunization: Rh administration is suggested for non-sensitized Rh D-negative individuals who have experienced threatened, spontaneous, or induced abortion after 12 weeks gestation[21].
- The Society of Family Planning: Rh testing is not recommended prior to 12 weeks gestations for spontaneous, medications, or uterine aspiration abortion[8].
- Complete blood count to measure hemoglobin level is indicated if there is an increased risk of anemia; otherwise, it is unnecessary[7].
- Routine prophylactic antibiotics are not required; screen-and-treat is the preferred management strategy and it is performed by the prescriber[6].
