Medical abortion

Question 1

What is medical abortion?

Answer 1

medication to terminate pregnancy

Question 2

When can medical abortion be used?

Answer 2

Upto 70 days from the last menstrual period

Question 3

FDA. Name of the medication abortion?

Answer 3

Misopristol and Mifepristone

Question 4

Medical guideline for eligibilily or medical abortion?

Answer 4

• Parental consent for minors (required in some states)
• Amenorrhea with positive pregnancy test
• Pelvic or transvaginal ultrasound documenting pregnancy as <70 days
• Full medical and surgical information
• Cardiovascular, thyroid, pulmonary, autoimmune, metabolic, and renal conditions
• Infectious disease (sexually transmitted infections [STIs], hepatitis, HIV)
• Mental health conditions
• Surgeries
• Allergies
• Full psychosocial history
• Drug and alcohol use/abuse/dependence
• Tobacco use/dependence
• Intimate partner violence (IPV)
• Woman’s support system
• Cultural beliefs (especially regarding pregnancy and abortion)
• Full gynecologic/obstetrical history
• Menstrual history, LMP
• Gynecologic history
• Pap smear history
• High-risk behaviors
• Pregnancy history
• Contraceptive history and desire for contraception after procedure
• History of attempt to end a pregnancy via drugs of any type

Question 5

Ineligibility for medical abortion?

Answer 5

• Amenorrhea for >70 days or beyond LMP
• Intrauterine device (IUD) in situ
• Inconclusive pelvic or transvaginal ultrasound for intrauterine pregnancy
• Documented or suspected
• Extrauterine (ectopic) pregnancy
• Abnormal placenta development
• History of severe
• Adrenal failure
• Cardiovascular issues
• Liver disease
• Uncontrolled diabetes
• Current anticoagulant therapy or blood-clotting disorder
• Taking medication that interferes with misoprostol or mifepristone
• Allergy to mifepristone or misoprostol
• Steroidal medication therapies
• Adnexal mass

Breastfeeding

Question 6

What are other medication to be considered while giving misoprostol

Answer 6

RhoGAM (D)

•Given after oral dose of mifepristone to all women who test Rh negative

Antiemetics

• Ondansetron oral dissolving tablet (Zofran)
• Prochlorperazine (Compazine)

Antidiarrheals

•Loperamide (Imodium)

Pain medications

• Ibuprofen
• No opioids

Question 7

Sign of incomplete bleeeding?

Answer 7

• Uncontrolled bleeding
• Continued pregnancy symptoms 1 week after medical abortion
• Nausea/vomiting
• Breast tenderness
• Unexplained fever
• Failure to return to prepregnancy baseline