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Y3 OBS AND GYNAE > Termination of Pregnancy > Flashcards

Termination of Pregnancy Flashcards

1
Q

List some common causes of unplanned pregnancy

A 
Incorrect/failed contraception
Rape
Domestic abuse
Trafficking
Lack of knowledge/motivation
Lack of planning
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2
Q

What is the most commonly performed gynaecological procedure in the UK?

A

Termination of pregnancy

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3
Q

How many medical practitioners are required to sign off on an abortion under the 1967 act?

A

2

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4
Q

Ground for non-emergency termination of pregnancy rank A-E. What is ground A?

A

Continuation of pregnancy would involve risk to pregnant woman greater than if pregnancy were terminated

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5
Q

Ground for non-emergency termination of pregnancy rank A-E. What is ground B?

A

Termination if necessary to prevent grave, permanent injury to physical/mental state of woman

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6
Q

Ground for non-emergency termination of pregnancy rank A-E. What is ground C?

A

Pregnancy has not exceed 24th week of gestation and continuation of pregnancy would involve risk of injury to physical/mental state of woman

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7
Q

Ground for non-emergency termination of pregnancy rank A-E. What is ground D?

A

Pregnancy has not exceed 24th week of gestation and continuation of pregnancy would involve risk of injury to physical/mental state of existing children of pregnant woman

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8
Q

Ground for non-emergency termination of pregnancy rank A-E. What is ground E?

A

Substantial risk that if child is born it will suffer from physical or mental abnormality and be seriously handicapped

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9
Q

Ground for emergency termination of pregnancy rank F-G. What is ground F?

A

It was necessary to save the life of the woman

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10
Q

Ground for non-emergency termination of pregnancy rank A-E. What is ground G?

A

It was necessary to prevent grave injury to the physical/mental state of the woman

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11
Q

List some ethical factors that might come into play during termination of pregnancy

A 
Under 16
Learning disability
HIV +ve
Patient confidentiality
Evidence of abuse
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12
Q

Can a doctor opt out of termination of pregnancy?

A

Yes if he/she has conscientious objection due to personal/moral/religious beliefs

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13
Q

What are some important points for a doctor to remember if objecting to performing a termination of pregnancy?

A

Avoid discrimination of patient
Ensure patient’s treatment is not delayed or denied
Prompt referral to colleague
Treatment must be given in emergency setting

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14
Q

What is the legal limit for social termination of pregnancy? In NHS Tayside?

A

23 weeks 6 days (24 weeks)

18 weeks 6 days

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15
Q

What is the legal limit for termination of pregnancy due to fetal anomaly?

A

Any point of gestation

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16
Q

Medical termination can be given early, late or mid-trimester. What is the cut-off for each?

A

Early: up to 9 weeks
Late: 9-12 weeks
Mid-trimester: 12-24 weeks

17
Q

What are the 2 stages involved in medical termination of pregnancy?

A 
Oral mifepristone (anti-progesterone)
Vaginal/oral prostaglandin 24-48hrs later
18
Q

If someone undergoes early medical termination (before 9 weeks), they can undergo the 2nd stage (prostaglandin) at home. True/False?

A

True

Need to do pregnancy test after 2-3 weeks to make sure though

19
Q

What surgical methods can be used to terminate a pregnancy?

A 
Vacuum aspiration (6-12 weeks)
Dilation and evacuation (not used in Scotland)
20
Q

What are the indications for emergency contraception?

A

Unprotected sex
Missed pills
Late Depo injections
Expelled IUD/IUS

21
Q

What are the 3 methods of emergency contraception available?

A

Levonelle pill up to 72hrs post-UPSI
ellaOne pill up to 120hrs post-UPSI
IUD

22
Q

Which has the greater failure rate - Levonelle or ellaOne?

A

Levonelle

23
Q

What is the most common age group for termination of pregnancy?

A

20-24yo

24
Q

In what situation, may a doctor not have conscientious objection to TOP?

A

Treatment in event of an emergency

25
Q

What is discussed in an initial TOP consultation?

A 
Alternatives to termination
US scan
Full medical history
Suitable methods for TOP
Bloods
Prophylactic antibiotics
Counselling for contraception
26
Q

List complications of TOP

A 
Pain
Haemorrhage
Infection
Incomplete/failed procedure
Anaesthetic complications
Uterine perforation (surgical)
Cervical trauma (surgical)
Uterine rupture
27
Q

What aftercare should be provided for the patient?

A 
Urine pregnancy test at 2-3 weeks
Risk of ongoing pregnancy
AntiD within 72 hours
When to seek help (contact information)
Referral for SRH if indicated
Contraception advice
28
Q

Which method of contraception should be avoided after a medical TOP?

A

DMPA (high progesterone) that could interact with medical termination (anti-progesterone)

Y3 OBS AND GYNAE (44 decks)

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