Pregnancy termination Flashcards
1
Q
Demographics of women undergoing abortions
A
- 51% of all pregnancies are unintended, 40% of those end in induced abortion
- 33% of all women by age 45 will have abortion
- 2% of women btwn 15-44 have an abortion each year
- Majority of abortions are in women btwn 15-30 (50% are in women ≤25)
- 44% of women who have abortions are under FPL
- 50% of women who have abortions are black, 28% are hispanic
- 90% of abortions occur in 1st trimester (w/in first 12 wks), the remaining 10% occur in 2nd trimester (13-26 wks, most are btwn 13-20)
2
Q
Components of pregnancy options counseling
A
- 3 options: parenting, adoption, abortion
- Deliver pregnancy results in neutral manner, elicit pts feelings
- Provide info for each option and support their decision
3
Q
Methods for first trimester abortions 1
A
- 1st trimester: medical abortion, surgical abortion (dilation and curettage)
- Medical abortions: mifepristone followed by misoprostol
- Mech of action of mifepristone: antagonist of the progesterone receptor, leading to progesterone withdrawal in the uterus-> PG mediated detachment of embryo from decidua
- Mech action of misoprostol: PGE analog, it stimulates uterine contractions, cervical ripening
- Together the two drugs cause detachment and expulsion of embryo
4
Q
Methods for first trimester abortions 2
A
- 2 different regimens: FDA and evidence based (evidence based is better)
- Evidence based medical abortion: can be used up to 63 days of gestation, timing is more forgiving (first mifepristone, then misoprostol 6-72 hrs later)
- Side effects of medical abortion: vaginal bleeding, uterine cramping
- Surgical abortions: manual vacuum aspiration, electric vacuum aspiration
- Prep for surgical abortions: cervical dilation via misoprostol
5
Q
Methods for 2nd trimester abortions
A
- Medical induction and surgical aspiration (dilation and evacuation)
- Medical induction (induction of labor): single agent misoprostol (may be intra-vaginally), may add mifepristone
