Termination of pregnancy

Question 1

until how many weeks gestation is an abortion legal providing that continuation of the pregnancy poses a greater risk to the health/wellbeing of the pregnant patient and/or any existing children?

Answer 1

24 weeks

Question 2

3 circumstances in which an abortion is legal up until any point in the pregnancy

Answer 2

the mother’s life is at risk if the pregnancy continues

TOP will prevent “grave permanent injury” to the physical or mental health of the mother

the foetus is likely to be born with severe physical or mental handicap

Question 3

2 legal requirements for an abortion

Answer 3

2 registered medical practitioners must sign it off

it must be performed in an NHS facility or in a pre-approved facility by a registered medical practitioner

Question 4

what is Marie Stops UK?

Answer 4

a charity offering remote access to abortion up to 10 weeks (medications are taken at home)

Question 5

what is the process of having a medical TOP?

Answer 5

take mifepristone (anti-progesterone)

48 hours later take misoprostol (prostaglandin analogue)

Question 6

2 actions of the anti-progesterone medication mifepristone

Answer 6

relaxes the cervix

halts the pregnancy

Question 7

until how many weeks gestation is medical abortion able to be carried out?

Answer 7

medical TOP can be carried out at any stage of pregnancy but it is most appropriate at <9 weeks

Question 8

suggest 2 additional measures that will need to be taken if medical TOP is performed at 10 weeks gestation or later

Answer 8

additional misoprostol doses every 3 hours until expulsion

anti-D should be given if the mother is Rh -ve

Question 9

2 options for surgical TOP

which should be chosen and when?

Answer 9

cervical dilation and suction (up to 14 weeks)

cervical dilation and evacuation with forceps (14 to 24 weeks)

Question 10

when should anti-D be given to resus -ve patients prior to a surgical TOP?

Answer 10

basically always - NICE states that it should be “considered” in patients under 10 weeks gestation

Question 11

3 methods of cervical priming prior to surgical TOP

Answer 11

misoprostol

mifepristone (NB also softens the cervix)

osmotic dilators

Question 12

how long is it normal to have bleeding PV and abdo cramping for after a TOP?

Answer 12

up to 2 weeks (intermittently)

Question 13

at what point should a urinary pregnancy test be performed in order to check that the TOP has been a success?

Answer 13

3 weeks after the procedure

Question 14

5 complications of TOP

Answer 14

bleeding

infection (very common)

damage to the uterus, cervix, etc

failure of TOP

pain