Abortion

Question 1

Up to how many weeks is medical abortion indicated

Answer 1

</= 7weeks, requires b-hCG f/u in 2 weeks

Question 2

what are the options for 1st trimester abortions

Answer 2

medical
D&C
manual vacuum extraction

Question 3

MCC death during 1st trimester abortions

Answer 3

general anestethia

Question 4

What is the safest and most effective method of abortions

Answer 4

suction D&C (7-13 weeks)

Question 5

what are the agents used for medical abortions + MOA

Answer 5

• mifepristone: blocks progesterone stimulation and cuases embryo detatchment
• methotrexate: blocks DHF reductase and decreased cellular division and blocks placental proliferation
• misoprostol: ripens cervix, used with MTX to increase efficacy

Question 6

side effects of medical abortion

Answer 6

abd pain/cramps, uterine bleeding, N/V

Question 7

how is 2nd trimester abortion performed

Answer 7

D&E or induction of labor (IOL is better since intact fetus can be used for autopsy)

**D&E ~ D*C but requires wider cervical dilation + use of special forcept to extract fetal parts

Question 8

complication of 2nd trimester abortions

Answer 8

trauma, inf, retained tissue, uterine perforation

Question 9

how is labor induced for 2nd trimester abortions?

Answer 9

cervix is ripened with misoprostol –> amniotomy –> high dose oxytocin

Question 10

3rd trimester abortions are illegal after ___ wks

Answer 10

24

** unless necessary for preservation of maternal life