Pregnancy term

Question 1

what is abortion law in canada

Answer 1

none - legal by default

Question 2

what is abrotion data

Answer 2

1:4 for live births

Question 3

what is global abortion issue

Answer 3

only half are performed safely

- mostly in areas where it is illegal

Question 4

what is maternal death rate in abortions in africa compared to canada

Answer 4

1000x greater

Question 5

where are abortions done in canada

Answer 5

half clinic, half hosp

Question 6

who gets most abortions

Answer 6

young women

- teens have more abortions that births

Question 7

3 general reasons for abortions

Answer 7

1. social
2. fetal complications
3. maternal complications

Question 8

what age are most done at

Question 9

when does access become an issue

Answer 9

T2 only accessable in some place

- no one doing late term in canadas

Question 10

types of surgical ab in 1st tri (2)

Answer 10

1. MVA

2. suction DandC

Question 11

types of surgical ab in 2nd tri

Answer 11

dilatation and evacuation

Question 12

what is MVA

Answer 12

manual vacuum aspiration - hand held and suck it out

- up to 12 weeks GA

Question 13

what is suction DandC

Answer 13

1. dilate cervix with probe and maybe a softener
2. suck out with a vacuum
   up to 16wks GA

Question 14

what is dilatation and evac.

Answer 14

1. osmotic dilators of cervix
2. removal with forceps and suction
   up to 23 weeks

Question 15

possible pain mgmt options

Answer 15

1. cervical block
2. oral analgesics
3. conscious sedation
4. general

Question 16

indications for medical abortion

Answer 16

• only up to 8 weeks
• meds
• private
• cheaper
• good follow up required

Question 17

3 main medical options

Answer 17

1. mifipristone and misoprstol - approved
2. methotrexate and misoprostol - only if no mifi
3. misoprotol alone - common in illegal

Question 18

what is mifipristone (MOA)

Answer 18

not available in canada

• anti-progesterone
• alters endo
• induces bleeding
• softens cervix
• induces contractions

Question 19

MOA of methotrexate

Answer 19

• folic acid antagonist

- interferes with trophoblast development

Question 20

MOA of misoprostol

Answer 20

synthetic prostaglandin

• stims. uterine contractions
• induces cervical softening

Question 21

outcomes for metho and miso

Answer 21

90 -

Question 22

which is better - mife or metho

Answer 22

mife

Question 23

what is late term abortion

Answer 23

induction of labor

Question 24

steps for induction of labor

Answer 24

• misoprostol followed by oxytocin

- sometimes pretreat with KCl in fetal heart

Question 25

what are 2 adv. of induction of labor over DandE

Answer 25

1. intact fetus -better patho

2. opportunity to see fetus - grief and closure

Question 26

what is complication rate

Answer 26

minor - 1-5%

major - 0.1-2%

Question 27

3 immediate complications

Answer 27

1. uterine perforation
2. hemorrage
3. cervical laceration

Question 28

3 short term complications

Answer 28

1. pain
2. fever
3. bleeds

Question 29

what is evidence for long term complications

Answer 29

1. breats cancer - none
2. post-abortion syndrome - not good
3. future pregnancy outcomes - conflicting results