Abortion Flashcards
1
Q
Waiting times for abortion
A
- Assess in 1w
- Treat within 1w of assessment
No compulsory counselling/reflection time needed
2
Q
Specialist centres
A
- Refer if complex co-morbidities
- Minimise delays in care
3
Q
Providing information
A
- No inc risk of breast CA, infertility or MH issues
- Discuss medical vs surgical TOP
- Explain what happens after
- How to get emergency help
- Psychological support
- Contraception
4
Q
Assessing for need for scan
A
- Any RF for ectopic/high risk - Prev ectopic, PID, tubal surgery, pain.
PMH - Able to determine gestation from LMP
5
Q
Medical TOP info
A
- Avoids surgery
- Mimics miscarriage
- What products they might see
- Pain and bleeding
- How to be sure preg has ended
- When to go to ED
6
Q
MTOP contraindications
A
- ?ectopic- need scan
- Allergy to medications
- Severe uncontrolled asthma
- Chronic adrenal failure
- Inherited porphyria
7
Q
MTOP risks %
A
- Cont preg 1-2:100
- Further procedure
<14w 70:1000
>14w 13:100 - Infection 1:100
- Severe bleeding
<20w 1:1000
>20w 4:1000
8
Q
STOP info
A
- Under LA/sedation/GA
- No discomfort during procedure, some after
- SE- Bleeding, pain, nausea
9
Q
STOP contraindications
A
- No access to cervix- tumour, fibroid, FGM T3
- Very high BMI
- Anaesthetic risks
10
Q
STOP risks %
A
- Cont preg 1:1000
- Further procedure
<14w 35:1000
>14w 3:100 - Infection 1:100
- Severe bleeding
<20w 1:1000
>20w 4:1000 - Perforation 1-4:1000
11
Q
STOP options
A
- EVAC - sedation or GA
- MVA - with LA if <14w
12
Q
MVA procedure
A
- Use suction cannula 4-12mm
- DO NOT use sharp curretage
13
Q
Other considerations
A
- Stop anti coag if needed
- If on LT steroids- mife might affect these
- IUD- Remove before TOP
14
Q
Anti D
A
- All surgical TOP
- Medical TOP >10w
15
Q
Abx
A
- No routine prophylaxsis for MTOP
- STOP- offer Doxy 100mg BD 3/7
- Tell pt signs of infection and when to seek help
