flashcards_termination_pregnancy
What is the medical management protocol for termination of pregnancy?
200 mcg Mifepristone (oral) followed 24-48 hours later by misoprostol (vaginal, buccal, or sublingual).
What are the special considerations for termination of pregnancy after 21+6 weeks?
Feticide (intracardiac KCl injection) should be given to eliminate the possibility of aborted fetus showing any signs of life.
What is the surgical management option for termination of pregnancy less than 14 weeks?
Vacuum Aspiration.
What is the surgical management option for termination of pregnancy between 13+0 and 24+0 weeks?
Dilatation and Evacuation (D&E).
What are the risks of surgical management for termination of pregnancy?
Failure to end pregnancy, haemorrhage, infection, perforation.
Does termination of pregnancy affect future reproductive potential or increase the risk of ectopic pregnancy?
No, there is no effect on future reproductive potential or increase in the risk of ectopic pregnancy.
What should be discussed with all abortion patients regarding contraception?
Discuss the insertion of long-acting reversible contraception (e.g., copper IUD, LNG-IUS, Nexplanon).
How many doctors need to sign a form agreeing to termination of pregnancy?
Two doctors.
What prophylaxis should be offered to all rhesus D negative women having an abortion after 10+0 weeks GA?
Offer anti-D prophylaxis.
What should be explained to the patient about medical termination of pregnancy?
One pill will be taken by mouth followed by another in 24-48 hours either buccal/sublingual/oral. Bleeding can last about 2 weeks. Pregnancy test after 3 weeks. Occasionally unsuccessful and requires surgical removal.
What should be explained to the patient about surgical termination of pregnancy?
It involves gently dilating the cervix and removing the pregnancy tissue using a suction tube (only takes about 10 minutes). May need to ripen cervix beforehand. Can be done under local or general anaesthesia.
What support should be offered to patients after an abortion?
Explain that it is common to feel a range of emotions afterwards and provide resources and sources of support e.g., counselling or psychological interventions.
