Early termination of pregnancy: differences in gestational age estimation using Last Menstrual Period and Ultrasound in Mexico
ESC Congress Library. Darney B. May 10, 2018; 208143; ESC204
Blair Darney
Blair Darney
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Abstract
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Objective. We compared estimations of gestational age (GA) in days based on women's reported last menstrual period (LMP) versus ultrasonography (US) in Mexico City's public abortion program, Interrupcion Legal de Embarazo (ILE), for determining eligibility for legal medication abortion in Mexico City.   Methods. We conducted a retrospective chart review (43,255 clinical records of women seeking abortion services) at three facilities in the ILE program 2007-2015. We extracted two measures of GA from clinical records and calculated the proportion of under- and over-estimation of GA in days based on LMP versus US overall, and using three cut-offs (70, 84, and 98 days). Our main outcome measure was Under/Over-estimation of GA in days. We examined the correlation of the two measures and calculated the proportion of women who would have been provided services (medication abortion up to 70 days, first trimester abortion up to 84 and 98 days) based on LMP dating but were ineligible for services based on US dating. Results. On average, the US estimation was -0.98 days (SD=14.06; Median= -1; Range= -241- 265) less than the LMP estimation, indicating women overestimated their GA based on LMP. Overall, 38.5% of the sample underestimated and 51.4% overestimated GA based on LMP compared with US. Six percent of women had GA of 70 days by US and thus not eligible for medication abortion. A similar fraction, 5.4%, were eligible for legal first trimester abortion by LMP (98 days by US. Conclusions. Our results support using LMP to assess GA for eligibility for first trimester abortion. Lack of US technology should not be a barrier to providing first trimester abortion services.
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