RT Journal Article SR Electronic T1 Utility of a routine ultrasound for detection of ectopic pregnancies among women requesting abortion: a retrospective review JF BMJ Sexual & Reproductive Health JO BMJ Sex Reprod Health FD British Medical Journal Publishing Group SP bmjsrh-2020-200888 DO 10.1136/bmjsrh-2020-200888 A1 Clara I Duncan A1 John J Reynolds-Wright A1 Sharon T Cameron YR 2020 UL http://jfprhc.bmj.com/content/early/2020/12/29/bmjsrh-2020-200888.abstract AB Introduction Routine ultrasound may be used in abortion services to determine gestational age and confirm an intrauterine pregnancy. However, ultrasound adds complexity to care and results may be inconclusive, delaying abortion. We sought to determine the rate of ectopic pregnancy and the utility of routine ultrasound in its detection, in a community abortion service.Methods Retrospective case record review of women requesting abortion over a 5-year period (2015–2019) with an outcome of ectopic pregnancy or pregnancy of unknown location (PUL) at a service (Edinburgh, UK) conducting routine ultrasound on all women. Records were searched for symptoms at presentation, development of symptoms during clinical care, significant risk factors and routine ultrasound findings.Results Only 29/11 381 women (0.25%, 95% CI 0.18%, 0.33%) had an ectopic pregnancy or PUL (tubal=18, caesarean scar=1, heterotopic=1, PUL=9). Eleven (38%) cases had either symptoms at presentation (n=8) and/or significant risk factors for ectopic pregnancy (n=4). A further 12 women developed symptoms during their clinical care. Of the remaining six, three were PUL treated with methotrexate and three were ectopic (salpingectomy=2, methotrexate=1). In three cases, the baseline ultrasound indicated a probable early intrauterine pregnancy.Conclusions Ectopic pregnancies are uncommon among women presenting for abortion. The value of routine ultrasound in excluding ectopic pregnancy in symptom-free women without significant risk factors is questionable as it may aid detection of some cases but may provide false reassurance that a pregnancy is intrauterine.