Termination of pregnancy

Question 1

What proportion of pregnancies are terminated worldwide?

Answer 1

1 in 5

Question 2

What proportion of women in the UK with have had a TOP before the age of 45?

Answer 2

1/3rd

Question 3

How many TOP’s are carried out in the UK each year?

Answer 3

200,000

Question 4

What proportion of TOP’s occur before 12 weeks gestation?

Answer 4

> 90%

Question 5

When can a TOP take place under ‘A’ of The Abortion Act 1967?

Answer 5

There is a risk to the woman’s life if the pregnancy continues

Question 6

When can a TOP take place under ‘B’ of The Abortion Act 1967?

Answer 6

Termination is necessary to prevent permanent grave injury to the physical or mental health of the woman

Question 7

When can a TOP take place under ‘E’ of The Abortion Act 1967?

Answer 7

There is substantial risk that is the child were born he/she would suffer such physical or mental abnormalities as to be seriously handicapped

Question 8

When can a TOP take place under ‘C’ of The Abortion Act 1967?

Answer 8

Continuance risks injury to the physical or mental health of the woman, greater than if terminated AND foetus <24/52

Question 9

When can a TOP take place under ‘D’ of The Abortion Act 1967?

Answer 9

Continuance risks injury to the physical or mental of existing children of the woman, greater than if terminated AND foetus <24/52

Question 10

Under what ‘letter’ are most abortions conducted, and what proportion of abortions is this?

Answer 10

97% = carried out under C

Question 11

What is the form doctor’s have to sign for an abortion to take place?

Answer 11

HSA1

Question 12

What are the complications of TOP?

Answer 12

1. Failure to abort
2. Post-abrotion infection
3. Haemorrhage
4. Uterine perforation (surgical only)
5. Uterine rupture
6. Cervical trauma
7. Premature labour in future pregnancies (surgical only)

Question 13

When is fetecide required in a medical TOP?

Answer 13

KCl required beyond 21 weeks 6 days

Question 14

When is fetecide required in a surgical TOP?

Answer 14

KCl required beyond 23 weeks

Question 15

What drugs are used in a medical TOP?

Answer 15

Mifepristone + misoprostol

Question 16

What are the 2 methods of surgical TOP?

Answer 16

1. Vacuum aspiration

2. Dilation and evacuation (D&E)

Question 17

When is vacuum aspiration used?

Answer 17

Up to 14 weeks. Before 7 weeks medical abortion = more effective than surgical abortion

Question 18

When is D&E used?

Answer 18

Beyond 14 weeks

Question 19

What sedation is used in TOP?

Answer 19

Midazolam

Question 20

What is used to carry out cervical prep pre-surgical TOP, up to 14weeks?

Answer 20

Misoprostol

Question 21

What is used to carry out cervical prep pre-surgical TOP, beyond 14 weeks

Answer 21

Osmotic dilators (Dilapan) = superior, but misoprostol may be used up to 18 weeks