Termination of pregnancy Flashcards
What is the appropriate management of a woman = 10 weeks’ gestation requesting termination of pregnancy?
- Mifepristone 200mg
- Misoprostol 800 micrograms
What should a woman expect following medical termination of pregnancy?
- Symptoms typically start 2-3h after misoprostol
- Vaginal bleeding (heavy with clots, can continue for up to 2 weeks)
- Lower abdominal pain
- Most completely within 4h, almost all by 24h
What is the appropriate medical management for termination of pregnancy in a woman 10-13 weeks gestation?
- Mifepristone 200mg orally
- Repeated doses of misoprostol at 3h intervals
What is the appropriate surgical management for termination of pregnancy in a woman 10-13 weeks gestation?
- Surgical dilation and curettage
What is the appropriate management for termination of pregnancy in a woman beyond 13/14 weeks gestation?
Surgical dilation and evacuation
How is the cervix dilated in surgical management of termination of pregnancy?
Misoprostol or osmotic dilators
What are the complications of termination of pregnancy?
- Failure to end pregnancy
- Retained (non-viable) tissue
- Infection
- Haemorrhage
- Cervical tear
- Uterine perforation
When should a woman seek medical attention following termination of pregnancy?
- Very heavy bleeding (soaking 2+ pads per hour for 2 consecutive hours; symptoms of anaemia)
- Persistent pain and bleeding
- Offensive vaginal discharge
- High fever and systemically unwell
What is endometritis?
Infection of the lining of the uterus, may extend to the upper genital tract
What are the clinical features of endometritis?
- Persistent lower abdominal pain/tenderness
- Deep dyspareunia
- Persistent bleeding
- Unusual vaginal discharge
- Fever
- Cervical motion tenderness
What is the management of endometritis
- Broad-spectrum abx such as doxycycline or ceftriaxone
- Analgesia
- If septic, then supportive management also
