Termination of Pregnancy

Question 1

What are some medical indications for TOP? (2%)

Answer 1

Genetic or anatomical foetal abnormality

Severe maternal illness (congenital heart disease, renal disease)

Question 2

What documentation is used to report an abortion?

Answer 2

Blue form

Question 3

What happens at pre-TOP consultation?

Answer 3

Full medical history
Counselling
- Check that they're making the right decision
- Talk about the different methods of termination
Pelvic ultrasound
- Viability
- Location
- Singleton/multiple
Blood tests 
Family planning (contraception)
Pelvic examination
Consent 
Swabs/STI screening

Question 4

How is an unwanted pregnancy managed medically?

Answer 4

Mifepristone day 1 po (anti-progesterone)
Misoprostol day 3 po/pv (prostaglandin)

These need to be given in hospital

Question 5

What are the risks of medical management ?

Answer 5

Heavy bleeding, pain, retained products (& subsequent infection)

Question 6

How is an unwanted pregnancy managed surgically?

Answer 6

Dilatation and evacuation, done under general anaesthetic

Question 7

What are the risks of surgical management?

Answer 7

Bleeding, infection, pelvic organ damage, anaesthetic complications

Question 8

When can an unwanted pregnancy be managed medically and surgically ?

Answer 8

Medical: Up to 24 weeks
Surgical: Up to 15 weeks