abortion

Question 1

abortion <9wk - investigations + management

Answer 1

STI screen
pregnancy test ± USS
test for anti-D

prophylactic abx - risk PID

mifepristone - anti-prog
48h later - PG eg misoprostol to stimulate contractions
NSAID analgesia

Question 2

abortion management if 9-15wk

Answer 2

surgical dilation + suction of contents

Question 3

abortion management if >15wk

Answer 3

surgical dilatation + evacuation of contents

or, late medical abortion

Question 4

abortion counselling - things to ask/discuss

Answer 4

conception:
who + when conceived
protection + contraception
LMP

history:
STI history + offer test
gynae history
preg in past? morning after pill in past?

pregnancy:
any symptoms
reasons for termination
if have this baby how would it affect you

procedure: get other doctor to agree

followup:
support - anyone? offer if ever feel overwhelmed
safety net - blood loss, infection, ectopic symptoms
offer contraception

Question 5

termination - complications

Answer 5

failure
haemorrhage
PID
cervical damage