Pregnancy term Flashcards
what is abortion law in canada
none - legal by default
what is abrotion data
1:4 for live births
what is global abortion issue
only half are performed safely
- mostly in areas where it is illegal
what is maternal death rate in abortions in africa compared to canada
1000x greater
where are abortions done in canada
half clinic, half hosp
who gets most abortions
young women
- teens have more abortions that births
3 general reasons for abortions
- social
- fetal complications
- maternal complications
what age are most done at
when does access become an issue
T2 only accessable in some place
- no one doing late term in canadas
types of surgical ab in 1st tri (2)
- MVA
2. suction DandC
types of surgical ab in 2nd tri
dilatation and evacuation
what is MVA
manual vacuum aspiration - hand held and suck it out
- up to 12 weeks GA
what is suction DandC
- dilate cervix with probe and maybe a softener
- suck out with a vacuum
up to 16wks GA
what is dilatation and evac.
- osmotic dilators of cervix
- removal with forceps and suction
up to 23 weeks
possible pain mgmt options
- cervical block
- oral analgesics
- conscious sedation
- general
indications for medical abortion
- only up to 8 weeks
- meds
- private
- cheaper
- good follow up required
3 main medical options
- mifipristone and misoprstol - approved
- methotrexate and misoprostol - only if no mifi
- misoprotol alone - common in illegal
what is mifipristone (MOA)
not available in canada
- anti-progesterone
- alters endo
- induces bleeding
- softens cervix
- induces contractions
MOA of methotrexate
- folic acid antagonist
- interferes with trophoblast development
MOA of misoprostol
synthetic prostaglandin
- stims. uterine contractions
- induces cervical softening
outcomes for metho and miso
90 -
which is better - mife or metho
mife
what is late term abortion
induction of labor
steps for induction of labor
- misoprostol followed by oxytocin
- sometimes pretreat with KCl in fetal heart
what are 2 adv. of induction of labor over DandE
- intact fetus -better patho
2. opportunity to see fetus - grief and closure
what is complication rate
minor - 1-5%
major - 0.1-2%
3 immediate complications
- uterine perforation
- hemorrage
- cervical laceration
3 short term complications
- pain
- fever
- bleeds
what is evidence for long term complications
- breats cancer - none
- post-abortion syndrome - not good
- future pregnancy outcomes - conflicting results
