Health effects of medical abortion in the first trimester with or without routine ultrasound: project plan for a systematic review
In this project, we will conduct a systematic review of the health effects of medical abortion in the first trimester, comparing routine ultrasound for all individuals seeking abortion with other decision-making tools.
About the project
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Project period: 13.01.2026 - 29.06.2026 (Active)
- Coordinating Institution: Norwegian Institute of Public Health
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Project Manager:
- Gunn Elisabeth Vist, Reviews and Health Technology Assessments
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Project Participants:
- Gyri Hval, Reviews and Health Technology Assessments
- Liv Giske, Reviews and Health Technology Assessments
- Gisle Berg Helland, Reviews and Health Technology Assessments
Summary
In Norway, it has been common practice to confirm pregnancy with an ultrasound examination before an abortion, which often leads to waiting and increases risk of more pain and bleeding since the pregnancy has progressed further. Several other countries have now introduced earlier medication-induced abortion without routine ultrasound. We will conduct a systematic review of the health effects of medication-induced abortion in the first trimester after a preliminary examination with routine ultrasound of all who ask for abortion compared to other decision-making tools. Findings from this review will be used in a potential national guideline on abortion. We will conduct a systematic literature search for controlled studies that investigate the effect and safety of medication-induced abortion with or without routine ultrasound examination beforehand. Outcomes include serious health outcomes (such as large bleedings, pain, undiscovered pregnancy outside of uterus, need for hospitalization), patient satisfaction, quality of life, and resource use. Two reviewers will independently assess the titles and abstracts of the references retrieved, and then any relevant studies in full text, according to our pre-defined inclusion criteria. We will assess the risk of bias of included studies and conduct meta-analysis if studies are comparable. We will assess our confidence in the evidence using the GRADE approach.