TOP Flashcards
What is the gestation cut off for having an MVA?
12 weeks
At what gestation is there a higher failure rate with MVA?
<7 weeks
When should you use cervical preparation in STOP and what should be used?
> 14 weeks osmotic dilators are better ie diplam, but you can use misoprostol from 14-18 weeks
When should you use vacuum aspiration vs D+C?
<14 weeks vacuum aspiration, 14-16 can use vacuum with wide bore cannula >14 can use D+C
What type of drug is Mifepristone?
Steroidal anti-progestogen (SERM)
What is the mechanism of action of Mifepristone?
Detachment of the gestational sac, makes myometrium more sensitive to miso
What type of drug is Misoprostol?
Prostaglandin E1 analogue
What is the mechanism of action of Misoprostol?
Binds to myometrial cells to cause strong myometrial contractions leading to expulsion of tissue. This agent also causes cervical ripening with softening and dilation of the cervix.
At what gestation is fetacide needed?
21+6/40
Mife and Miso should be given ideally how long apart?
24-48 hours
In the UK we can now offer miso at home up to what gestation?
9+6 weeks
What is certificate A?
Must be signed by 2 Drs before the TOP
What is certificate B?
If TOP is performed in an emergency this must be signed by 1 Dr before or <24 hours after TOP
What is certificate HAS4?
Abortion Notification Forms must be sent to chief medical officer within 14 days of TOP
What is the risk of needing a blood transfusion with a STOP?
<20/40: <1 in 1000
>20/40: 4 in 1000
