I honestly can't remember if I did have another scan before - I know I did after, to check everything was clear. I imagine it would be a requirement before medical management but honestly can't remember - they were a few years (and two children) ago and it's all a bit of a miserable blur.
The sickness, still feeling pregnant etc was the reason I opted for medical management for the second and subsequent ones. I felt more in control making the choice to do something and get it over with within a known timeframe, rather than having to get on with my life (going to work, commuting on public transport etc) waiting for something to happen 'soon' but not knowing when or how bad it would be. And, to be brutally honest, I didn't see any point in prolonging the misery of nausea (I had it very badly on every occasion, severe HG in my last pregnancy) for no good outcome.
It might help to be prepared - even if you choose to wait, you can ask for prescription painkillers in case they're needed. With my first, I didn't realise how bad it could be, so was completely unprepared and my H at the time was at work. With subsequent ones, I was able to be prepared, at home, phoned in sick to work in advance rather than in the middle of everything, and it was certainly easier logistically, rather than the awful mess (in every sense) the first time round.