Current through Register Vol. 43, No. 39, September 26, 2024
(a) Each applicant and each licensee shall
ensure written policies and procedures are developed and implemented for the
medical screening and evaluation of patients. A medical screening and
evaluation shall be completed on each patient before an abortion procedure is
performed.
(b) The medical
screening and evaluation shall consist of the following:
(1) A medical history shall be completed,
including the following:
(A) Reported
allergies to medications, antiseptic solution, or latex;
(B) obstetric and gynecologic
history;
(C) past
surgeries;
(D) medication currently
being taken by the patient; and
(E)
any other medical conditions.
(2) A physical examination shall be performed
by a physician, including a bimanual examination to estimate uterine size and
palpation of the adnexa.
(3) An
ultrasound evaluation shall be completed for any patient who elects to have an
abortion of an unborn child. The physician shall estimate the gestational age
of the unborn child based on the ultrasound examination and obstetric standards
in keeping with established standards of care regarding the estimation of the
age of the unborn child and shall verify the estimate in the patient's medical
history. The physician shall keep the original prints of each ultrasound
examination for each patient in the patient's medical history file. The
original prints may consist of a digitized record or an electronic
record.
(4) The appropriate
laboratory tests shall be completed, including the following:
(A) For an abortion performed in a medical
emergency and in which an ultrasound examination is not performed before the
abortion procedure, urine or blood tests for pregnancy, which shall be
completed before the abortion procedure;
(B) a test for anemia as indicated;
(C) determination of Rh factor or Rh typing,
unless the patient provides written documentation of blood type acceptable to
the physician; and
(D) other tests
recommended by the physician or the medical director on the basis of the
physical examination, which may include tests for chlamydia and gonorrhea and
other cultures, syphilis serology, and a papanicolaou procedure.
(c) Each licensee shall
ensure that another individual is present in the room during a pelvic
examination or an abortion procedure. If the physician conducting the
examination or the procedure is male, the other individual in the room shall be
female.
(d) The physician or health
care professional shall review, at the request of the patient, the ultrasound
evaluation results with the patient before the abortion procedure is performed,
including the probable gestational age of the unborn child.
