Medical Abortions

Question 1

Medical abortions indications

Answer 1

Termination in 1st or 2nd tri (up to 9 wks)
Surgical alternative (privacy and autonomy, telemedicine supported)

Question 2

Medical abortions medications

Answer 2

Mifepristone 1 dose orally
36-48 hrs later= misoprostol 4 tablets bucally (cheeks and gums, swallow after 30 mins)

Question 3

Medical abortions contraindications

Answer 3

• travel time to hospital 12 hrs+ w/in 14 days of mifepristone
• anticoagulants or hemorrhagic disorder
• IUD that cannot be removed
• confirmed or suspected ectopic pregnancy
• long-term oral glucocorticoids

Question 4

Medical abortion precautions

Answer 4

• Diabetes requiring insulin (N/V risk and dehydration)
• Severe anaemia
• Epilepsy (seizures induced by pain or vomiting)
• Unstable asthma
• Long-term asthma preventer therapy

Question 5

Dispensing MS-2 step depends on confirmation of

Answer 5

• Procedure fully explained to Pt
• Pt received copy of info

Question 6

MOA of mifepristone

Answer 6

Down-regulation of progesterone-dependent genes w/ decimal necrosis. Detachment of products of conception.
- block progesterone action
- soften/dilate cervix, increase uterine activity and sensitivity to misoprostol

Question 7

Mifepristone ADR and counselling

Answer 7

• Vomiting
• Single oral dose as 1st step
• If you vomit in 1st hour after taking, dose must be repeated
• About 5% of pregnancies are expelled on step 1

Question 8

Misoprostol MOA

Answer 8

• dilate cervix and induce contraction
• synthetic prostaglandin E1 derivative- oral, vaginal, buccal, or sublingual administration