Termination Of Pregnancy Flashcards
What is involved in early medical termination?
Mifepristone 200mg PO to block progesterone
36-48 hours later misoprostol 800 mcg is administered to dilate the cervix and cause the lining of the uterus to shed
Takes about 4-6 hours
Women experience bleeding and pain
Women can take simple analgesia
There is a risk of heavy bleeding
When can early medical termination be performed?
Up to 9 weeks
How is late medical termination performed?
Mifepristone 200mg given and 36-48 hours later misoprostol given
Another dose of misoprostol may be necessary - can give misoprostol at 3-4 hourly intervals
Usually takes a day, but may be required to stay overnight
When is late medical termination performed?
9-20 weeks
When is late medical abortion performed?
20-24 weeks
How is late medical termination performed?
Mifepristone then Misoprostol administered vaginally to induce contractions and ‘labour’
This lasts 6-12 hours
Can use dilation and evacuation after to completely remove contents
When is vacuum aspiration termination of pregnancy performed?
7-15 weeks
How is vacuum aspiration termination performed?
A suction currette is used to evacuate the uterine contents
Misoprostol may be delivered to dilate the cervix
Done under local or GA as a day case
Quick and easy, done in a day
Increased risk of uterine damage
Increased risk of infection
When is dilatation and evacuation performed?
15-20 weeks
How is dilatation and evacuation performed?
Done under GA involves using dilators to dilate the cervix and forceps and suction to remove the contents
Takes 10-20mins
After 14 weeks, use osmotic dilators
When is late surgical abortion performed?
20+ weeks
How is late surgical abortion performed?
Fetocide is performed, by injecting a potassium chloride injection into the foetal heart under ultrasound guidance and misoprostol administered
What should be performed prior to the TOP?
USS to confirm dating of foetus
Swabs for chlamydia and gonorrhoea
Discuss future contraception
Bloods - FBC, blood type, maybe clotting, hepatitis and HIV
Can people under 16 have to tell their parents?
No
They do not have to tell anyone about the pregnancy
Can abortion be performed after 24 weeks?
Yes
If serious risk to the woman’s health
Or
Substantial risk of physical or mental disability if the baby is born
