Abortion Counselling Flashcards
what preexisting conditions should you ask about in abortion counselling
coagulation disorder
cardio resp compromise
in which patients should you confirm GA by U/S when offering abortion counselling
when GA is in question
if intrauterine pregnancy is uncertain
patients undergoing 2nd trimester procedures
what STI should you screen for specifically
BV
sig reduction in post op PID if pre op tx with flagyl
what should you give all Rh- women undergoing abortion
rhogam after termination
first trimester abortion option
medical
vacuum aspiration–manual or traditional vacuum
until how many weeks can medical abortion be offered
less than 8 weeks
until how many weeks can vacuum aspiration abortion be offered
manual–less than 10 weeks
traditional–less than 13 weeks
what meds are used for medical abortion
off label use
methotrexate + misoprostol or just misoprostol alone
how does medical vs surgical abortion compare
medical is safer but less effective
what % of medical abortions are completed (successful)
complete abortion rate is 90% or more in GA up to 49 days, and efficacy declines with increasing GA
how quickly do medical abortions progress
78% of women pass products of conception (POC) within 24h
remainder usually have delayed medical termination which lasts over several days
in what % of patients will you have to still do a surgical evacuation after attempting a medical abortion
about 1% of people will have an ongoing viable gestation that will require surgical evacuation
contraindications to medical abortion
sensitivity to medications known coagulopathy active liver or renal disease severe anemia acute IBD
second trimester abortion options
D&C > induction of labour > hysterectomy/hysterotomy
what do you need to do to prepare for D&C
place mechanical or pharmacological dilators PV or PO 4-48 hours prior to procedure
how quickly should pregnancy symptoms dissipate in abortion counselling
within one week of the pregnancy termination; normal menses should return by 6 weeks
when should you f/u abortion
2-4 weeks after
what should you educate patients to watch for with regard to complications while abortion counselling
recognize fever, pelvic pain, uterine elnargement, heavy bleeding, passage of tissue, and ongoing pregnancy symptoms and should seek care
how long should you avoid vaginal intercourse and tampons for
2 weeks to avoid TSS
is hcg useful to diagnose incomplete abortion
no–is detectable as long as 60 days post procedure
what are the most common emotional reactions after pregnancy termination
relief
transient guilt
sadness
sense of loss
*address these feelings
does the choice to terminate place women at higher risk of subsequent depression or other psychiatric diagnoses
no
