Abortion Flashcards
What patients are more likely to get abortions? What are barriers to abortion access?
Poor women and minorities.
Barriers are geographic, financial
How many women have had an abortion?
40% of women
When are most abortions done? Why would they be done at another time?
Most abortions are performed in first 9 weeks of gestation.
Later abortions usually due to complications, instances of rape and/or financial issues.
When is abortion death rate highest? What are the leading causes?
Highest when performed later. Risks include anesthesia, infection, embolism, hemorrhage
What tool is used for uterine aspiration?
Smooth cannula
What should be done immediately after uterine aspiration?
Tissue inspection
What are recognizable tissues at weeks 5-7?
At 8-9 weeks?
At 9-12 weeks?
5-7: Decide and trophoblastic villi
8-9: Decidua, placenta (pinker/denser), possibly embryo/fetus
9-12: Decidua, placenta (opaque, dense, pink), fetal parts
For how many weeks gestation can you use medical abortion? How does it work?
Up to 70 days– it induces uterine contractions and expulsion of pregnancy tissue
What are the three medications that are used for medical abortions? In what combinations?
Mifepristone+misoprostol
Methotrexate+misoprostol
Misoprostol alone
What is mifepristone’s mechanism of action? How long does it take to work, and how effective is it?
It binds to the progesterone receptor and blocks it.
It takes 4-6 hours to complete and is 93-98% effective
What is misoprostol? What are its physiological effects?
Think uterine, cervical, GI and systemic
It’s a prostaglandin (E1) analog
Uterus: Stimulates contractions
Cervical: Softens/primes cervix and prevents/treats ulcers
GI: nausea, vomiting and diarrhea
Systemic: fevers/chills
What is the mechanism of methotrexate? How long does it take to work and how effective is it? What are rare side effects (3)?
It’s an anti-folate– blocks division of rapidly dividing cells.
It takes between 3-45 days to complete abortion and is 90-95% effective
AE: alopecia, leukopenia, interstitial pneumonitis
Describe a typical medical abortion process.
What are effects of misoprostol?
Day 1: Counseling and shit
Day 2-5: mifepristone given on site with misoprostol taken at home (buccal or vaginal admin).
1-2 weeks: Follow-up to confirm expulsion
Misoprostol results in vaginal bleeding/cramping 2-4 hours after administration. Can continue for 2-4 weeks.
How soon after abortion is it possible to get pregnant?
First month.
