Abortion (Adcock)

Question 1

Threatened abortion

Answer 1

vaginal bleeding before 20 weeks; cervix is closed; increased risk for preterm birth

Question 2

Incomplete abortion

Answer 2

open cerival os and bleeding with products of conception still present (fetal parts)

Question 3

Missed abortion

Answer 3

less than 20 weeks with an empty gestational sac or fetal pole with absent cardiac activity; cervical os ic closed

Question 4

Spontaneous abortion

Answer 4

pathological process resulting in unexpected termination of pregnancy before 20 weeks

Question 5

Inevitable abortion

Answer 5

heavy vaginal bleeding; cervical os is open and effaced

Question 6

Self Medicated Abortions (SMAs)

Answer 6

self admin abortion meds (misoprostol w/ or w/o mifepristone); as effective as provider admin abortion

Question 7

Medical abortion

Answer 7

indicated up to 11 weeks (77 days); if beyond 63 days a second dose of misoprostol given; effects are NOT likely to be reversed

Question 8

What is the most effective regimen and dose for a medical abortion?

Answer 8

mifepristone 200 mg orally; second choice misoprostol 800 mcg (less favored due to increased risk for infection)

Question 9

Second Trimester Medical Abortion

Answer 9

medical supervised procedure at 12-25 weeks; mifepristone AND misoprostol utilized w/ IV antibiotics

Question 10

Contrindications to mifepristone/misoprostol

Answer 10

ectopic pregnancy, IUD, chronic renal failure, steroid suppression, inherited porphyria, allergy

Question 11

All patients should have what physical exam prior to an abortion?

Answer 11

pelvic exam

Question 12

The Dobbs decision, 24th June 2022

Answer 12

overturned Roe v Wade, removed the constitutional right to an abortion

Question 13

Missouri legality on abortion

Answer 13

complete ban on abortion, except in medical emergency. A medical emergency is a life threatening condition, one insidious risk of “substantial and irreversible” physical harm. The morning after pill and IUD are not prohibited; abortion due to chromosomal abnormalities/malformation are prohibited

Question 14

Kansas legality on abortion

Answer 14

rejected constitutional amendment; there are two abortion clinics in Wichita and two in Kansas City; Kansas prohibits abortion after 22 weeks; required 24 hour waiting period and counseling; limited public funding and private insurance coverage

Question 15

Emergency contraception

Answer 15

meant to prevent pregnancy after intercourse, but medical pregnancy termination is proper after a pregnancy has been established; oral agents inhibit or delay ovulation; the copper IUD placed by a provider affects sperm viability and function