termination of pregnancy Flashcards
1967 Abortion act
2 Drs to sign to support woman’s request
- continuing the pregnancy has grave risk to the life of the pregnant woman – greater than if pregnancy terminated
- termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman
- under 24wks and continuation of pregnancy involves greater risk than if the pregnancy were terminated of injury to the physical or mental health or the pregnant woman
- under 24wks and continuation of pregnancy involves risk greater than if the pregnancy were terminated of injury to the physical or mental health of the existing child(ren) of the pregnant woman
- there is a substantial risk that if the child were born it would suffer physical or mental abnormalities as to be seriously handicapped
Medical abortion - when
any gestation - may be most appropriate earlier on though
MTOP - process
- mifepristone
2. misopristol 1-2 days later
Mifepristone
anti-progestogen
halts pregnancy and relaxes cervix
Misoprostol
prostaglandin analogue
soften cervix + stimulate uterine contractions
MTOP - antiD
rhesus negatieve women who are 10wks+ should have anti-D prophylacis
STOP - priior to procedure
cervical priming - soften and dilate cervix
use misoprostol, mifepristone or osmotic dilators
STOP - up to 14wks
cervical dilation and suction of uterus contents
STOP - 14-24wks
cervical dilatation and evacuation using forceps
STOP - antiD
Rhesus negative women having a surgical TOP should have anti-D prophylaxis. The NICE guidelines (2019) say it should be considered in women less than 10 weeks gestation.
post-abortion care
urine pregnancy test performed 3wks after abortion to confirm it is complete
discuss contraception
complications
bleeding pain infection failure damage to cervix, uterus
