Termination of Pregnancy/Abortion(1)

Question 1

When can it be done before 24 wks?

When can it be done at any time?

What are the 2 legal requirements for a TOP?

Answer 1

➊ If continuing the pregnancy involves greater risk to the physical and mental health of the mother or existing children of the family

➋ If:
• Continuing the pregnancy is likely to put the mother’s life at risk
• Terminating will prevent “grave permanent injury” to the mother
• There’s substantial risk that the child will suffer physical or mental disabilities

➌ • 2 registered medical practitioners must sign to agree
• Must be carried out by a registered medical practitioner in a NHS hospital or approved premise

Question 2

What is involved in a medical TOP?
→ When is this the most appropriate option?

What is involved in a surgical TOP?

Answer 2

➊ First Mifepristone (anti-progesterone to discontinue pregnancy), followed by Misoprostol (prostaglandin for expulsion of uterine contents) 1/2 days later
→ Earlier in pregnancy, but can be done at any time

N.B. In a miscarriage, only Misoprostol is needed as the pregnancy has already ended.

➋ • Prepped by cervical ripening with medications like misoprostol, mifepristone or osmotic dilators
• Options are:
‣ Suction of uterine contents (< 14 wks)
‣ Cervical dilatation and evacuation/curettage using forceps (14-24 wks)

Question 3

What needs to be done post-TOP?

What are some of the complications that can occur?

Answer 3

➊ Pregnancy test after 3 wks to confirm it’s complete

➋ • Bleeding
• Pain
• Infection
• Failure of abortion
• Structural damage