TOP

Question 1

What does abortion act 1967 permit?

Answer 1

Abortion in Scotland, England and Wales (ammended by human fertilisation and embryology act 1990)

Question 2

When can abortion act 1967 allow TOP uo until?

Answer 2

23 + 6 weeks
No gestational limit if substantial risk that if child were born it would suffer from mental/physical abnormalities= seriously handicapped

Question 3

Abortion regulations 2020?

Answer 3

NI allows abortion up to 11+6 weeks, beyond 12= foetal abnormality

Question 4

How many Drs need to be involved inthsi decision?

Answer 4

2 need to sign

Unless emergency then 1

Question 5

Methods of abortion?

Answer 5

Surgical
OR
Medical

Question 6

Clinical assessment of gestation?

Answer 6

Estimated by LMO +/- date of +ve UPT 
Palpable uterus (>12 weeks)

Question 7

US assessment of gestation?

Answer 7

Abdominal or transvaginal US

Done via risk assessment

Question 8

Medical TOP involves?

Answer 8

2 medications
Mifepristone 200mg PO
Misoprostol 800mcg PV/SL (24-48 hours later)

Question 9

Abortion <12 weeks pregnancy?

Answer 9

Can self-administer mife/miso at home

• Further misoprostol (400mcg) if not bleeding within 4 hours and less than 10 weeks
• 10 -11+6 weeks, 3 further doses of misoprostol (400mcg) provided

Question 10

Medical TOP >12 weeks?

Answer 10

Inpatient

Repeated dose of PV misoprostol 800mcg PV then 400mcg 3 hourly PV/PO/SL up to 4

Question 11

How long is MTOP available for?

Answer 11

19+6 weeks in most areas of Scotland, >20 weeks requires England travel

Question 12

What is surgical TOP?

Answer 12

Removal of pregnancy via surgical procedure (under anaesthesia)

Question 13

How do you prime cervix for STOP?

Answer 13

Misoprostol or osmotic dilators

Question 14

Surgical Abortion <14 weeks?

Answer 14

Electric vacuum aspiration (GA)

Manual vacuum aspiration (up to 10 weeks, LA)

Question 15

STOP >14 weeks involves?

Answer 15

Dilatation and evacuation

Question 16

STOP available til when in scotland?

Answer 16

Up to 14 weeks

>14 weeks= specialist centre in England

Question 17

Complications of abortion?

Answer 17

Haemorrhage+/- blood transfusion 
Failed/incomplete abortion 
Infection 
Uterine perforation 
Cervical trauma

Question 18

Prophylaxis at time of abortion?

Answer 18

Those undergoing STOP get AB
-7 days doxycycline BD
OR
1g oral azithromycin + 500mg daily for 2 days

Question 19

Ig high risk VTE for abortion patient what you do?

Answer 19

Start LWMH before abortion +/- continuing for longer

Question 20

Hormonal methods of contraception can be started when after abortion>

Answer 20

Anytime after MTOP/STOP including day of