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Reproduction Week 2 2018/19 > 2: Unplanned pregnancy and psychosocial problems > Flashcards

2: Unplanned pregnancy and psychosocial problems Flashcards

1
Q

How many abortions are carried out in the UK every year?

A

200,000

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2
Q

Failure of what is a common reason for abortion?

A

Failure of contraception

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3
Q

Apart from failure of contraception, what are some other reasons women choose to have an abortion?

A

Pregnancy as a result of abuse

Lack of knowledge about implications of pregnancy, family planning

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4
Q

If you become pregnant, what are your three options?

A

1. Continue with the pregnancy and keep the baby

2. Continue with the pregnancy and put the baby up for adoption

3. End the pregnancy via termination

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5
Q

The rates of abortion are highest in which age group?

A

20 - 24

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6
Q

Having an abortion is (safer / more dangerous) than carrying a baby to term.

A

safer

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7
Q

Abortion rates are strongly associated with which social factor?

A

Deprivation

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8
Q

Which legal act was written to regulate abortions?

A

Abortion Act (1967)

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9
Q

Under the Abortion Act, who has to approve an abortion before it occurs?

A

Two registered medical practioners

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10
Q

Under the Abortion Act, where do abortions have to take place?

A

NHS hospitals or NHS-approved centres

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11
Q

Under the Abortion Act 1967, which forms need to be filled out

a) by two medical practitioners for a planned abortion
b) by one medical practitioner for an emergency abortion?

A

a) Certificate A

b) Certificate B

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12
Q

In general, when is abortion acceptable?

A

When risks (physical / mental) of carrying baby to term are greater than the benefits for mother or existing children

When baby would be born with severe physical or mental abnormalities

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13
Q

After which week in gestation can an abortion NOT be performed?

A

Week 24

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14
Q

When is an emergency abortion acceptable?

A

When abortion is necessary to save the life of, or prevent serious physical / mental harm to, the pregnant women

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15
Q

Can abortions be performed for under 16s?

A

Yes - if they are assessed to be competent

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16
Q

As a doctor, which term is used to describe opting out of any procedures related to abortion?

A

Conscientious objection

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17
Q

If you conscientiously object to carrying out procedures related to abortion or giving advice to patients, what must you do?

A

Hand patient over to a qualified medical practitioner who can look after them instead

18
Q

Treatment in the event of an ____ may not be denied on the grounds of conscientious objection.

A

emergency

19
Q

How long after being referred will patients expect to be seen in a termination of pregnancy clinic?

A

2 weeks

20
Q

What happens at the first appointment in the TOP clinic?

A

Discussion of abortion and certainty to proceed

Ultrasound abdomen to make sure pregnancy is uterine i.e not ectopic

Full medical history

Discussion of abortion methods

21
Q

While an abortion is being arranged, patients may be screened for which diseases?

A

STIs

22
Q

Which drugs may patients be given in the time between their initial consultation and termination of pregnancy?

A

Contraception

Prophylactic antibiotics

23
Q

In terms of gestational age, when is the cutoff for abortion?

A

24 weeks

24
Q

The legal cutoff for abortion is 24 weeks.

What does this mean practically?

A

Abortion needs to be carried out by 23 weeks 6 days

25
Q

The legal cutoff for abortion is 24 weeks.

What is the exception to this law?

A

Foetal abnormalities

If present, abortion is legal at any gestational age

26
Q

The legal cutoff for abortion is 24 weeks.

When is the NHS Tayside cutoff?

A

19 weeks (medical abortion)

12 weeks (surgical abortion)

27
Q

Which drugs are used in medical termination of pregnancy?

A

1. Mifepristone - anti-progesterone which causes the endometrium to become unviable for pregnancy

2. Then misoprostol 1-2 days later - prostaglandin which causes uterine contractions, expelling the pregnancy

28
Q

Misoprostol is given every ___ hours until abortion occurs.

A

three hours

29
Q

If a medical abortion fails, what may have to be carried out?

A

Surgical abortion

30
Q

Surgical abortion may be carried out up to which point in gestation?

A

12 weeks

Or in an emergency e.g following failed medical abortion

31
Q

What are two methods of surgical abortion?

A

Vacuum aspiration

Dilatation and evacuation

32
Q

How may the cervix be primed for surgical abortion?

A

Misoprostol

Prostaglandin analogue, encourages uterine contractions > expellation of products

33
Q

What form of contraception may be fitted during surgical abortion?

A

Long-acting reversible contraception

e.g intrauterine implant, system (hormones) or device (copper)

34
Q

What complications can be caused by both medical and surgical abortion?

A

Pain

Haemorrhage

Infection

Incomplete abortion

Uterine rupture

35
Q

What is a rare complication of medical and surgical abortion which is a medical emergency?

A

Uterine rupture

36
Q

What test are women given post-abortion?

A

Urine pregnancy test

37
Q

Which drug are women given post-abortion?

A

Anti-D injections

To prevent Rhesus disease in subsequent pregnancies (if mum is Rhesus-negative and foetus was Rhesus-positive)

38
Q

Women MUST be encouraged to use ___ post-abortion.

A

Contraception

39
Q

What are psychosexual problems?

A

Disturbance of sexual functioning

Which may be caused by non-organic problems (psychological, emotional)

40
Q

What are the most common psychosexual problems for men?

A

Loss of libido

Premature ejaculation

Performance anxiety

41
Q

What are the most common psychosexual problems for women?

A

Anorgasmia

Vaginismus

Loss of libido

Reproduction Week 2 2018/19 (9 decks)

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