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George Rubin, MD; Willard Cates, JR, MD
Atlanta

JAMA. 1981;246(10):1089.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

Dr Crittenden suggests the routine use of ultrasonography before every abortion procedure. This approach causes us considerable concern.

Assuming 100% sensitivity and 100% specificity, we would expect, on the average, 2,500 ultrasonography procedures would be needed to diagnose one ectopic pregnancy. Based on a minimum charge of $50 for each procedure, the cost to patients would total $125,000 to diagnose one case of ectopic pregnancy, which could be detected with the method outlined in our article. Furthermore, adding $50 to the cost of an abortion could cause some women to delay an abortion procedure while obtaining sufficient funds to pay for the procedure; this delay itself could lead to an increase in morbidity and mortality.¹ Even the scheduling of the ultrasonography before an abortion, especially if the former is performed outside of the abortion facility, could delay the time of the operation.

If we assume the test . . . [Full Text PDF of this Article]

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