Ultrasound is done by the doctor before the procedure for accurate dating, to make sure that the pregnancy is not ectopic (outside of the uterus) and to determine if there are any abnormalities that may affect the procedure. Another ultrasound is performed afterwards to make sure the procedure was complete.
You may choose what type of anesthesia you would like. Most patients do not want to see, feel, or hear anything and choose IV anesthesia.
Dr. Seletz no longer offers routine medical abortions with RU486 following reports of serious complications associated with this method (Fischer et al; N Engl J Med 2005: 353:2352-60). For patients interested in medical abortions we recommend Dr. Emanuel Brandeis www.ru486is here.com.
Medical abortion with Methotrexate is available for early ectopic pregnancy. Methotrexate a folic acid antagonist has been used in the United States and Canada since 1995.
Abortion between 13 – 18 weeks of pregnancy is most commonly a D&E (dilation and evacuation). The dilation is done on the first day by mechanically dilating the cervix and then inserting laminaria which remain in place overnight. In the early part of the second trimester (13 or 14 weeks) the cervix can be prepared with the drug misoprostol which is given 4 hours prior to the evacuation.
Abortion after the second trimester of pregnancy is done for fetal indication and requires a referral from a perinatologist or maternal-fetal-medicine specialist. Dr. Seletz is one of a few physicians in the United States who has experience doing these procedures. If you are in need of this service, we will discuss your circumstances with you in person or by phone and we do require faxed medical records from your referring physician.