Termination Of Pregnancy Flashcards
Abortion
Elective procedure to end the pregnancy
When is the latest time a woman can have an abortion
24 weeks
Specific criteria required to justify the decision to proceed with an abortion after 24 weeks
If continuing the pregnancy involves greater risk to the physical or mental health of:
- the woman
- existing children of the family
When can an abortion be performed at any time during the pregnancy
Continuing the pregnancy is likely to risk the life of the woman
Terminating the pregnancy will prevent “grave permanent injury” to the physical or mental health of the woman
There is “substantial risk” that the child would suffer physical or mental abnormalities making it seriously handicapped
Legal requirements for an abortion
Two registered medical practitioners must sign to agree abortion is indicated
Carried out by a registered medical practitioner in an NHS hospital or approved premise
How to get pre-Abortion Care
Self referral or by GP, GUM or a family planning clinic
Medical Abortion
Mifepristone (anti-progestogen)
Misoprostol (prostaglandin analogue) 1 – 2 day later
How does Mifepristone work
Blocks the action of progesterone, halting the pregnancy and relaxing the cervix
Doses of misoprostol from 10 weeks of gestation
Additional misoprostol doses (e.g. every 3 hours) are required until expulsion
Anti - D prophylaxis
Rhesus negative women with a gestational age of 10 weeks + having a medical TOP should have anti-D prophylaxis
What factors influence the method of surgical abortion
Preference
Gestational age
Type of anaesthetic
Surgical preparation
Medications are used for cervical priming:
- misoprostol
- mifepristone
- osmotic dilators.
Osmotic dilators
Device inserted into the cervix, that gradually expand as they absorb fluid, opening the cervical canal
Options for surgical abortion
Cervical dilatation and suction of the contents of the uterus (usually up to 14 weeks)
Cervical dilatation and evacuation using forceps (between 14 and 24 weeks)
Post-Abortion Care
May experience vaginal bleeding and abdominal cramps intermittently for up to 2 weeks after the procedure
A urine pregnancy test is performed 3 weeks after
Contraception is discussed
Support and counselling is offered
