Unplanned pregnancy

Question 1

Describe the process of a medical abortion

Answer 1

—2 stage process:

1) Oral MIFEPRISTONE 200mg (anti-progesterone, RU486)
2) 24-48 hours later – Vaginal (or oral) prostagladin e.g. misoprostol, gemeprost

—Late/mid-trimester - Repeated doses of prostaglandin 3 hourly (max 5/24 hours)

—Early (<9wks) – option to complete the 2nd part at home

—Failed medical procedure may require surgical intervention

Question 2

describe the surgical TOP

Answer 2

—Cervical ‘priming’ – vaginal prostaglandin

Manual vacuum aspiration

can be performed under LA

6-13 weeks

Question 3

what are the three methods of emergancy sontraception?

Answer 3

• Oral
• Levonelle – up to 72hrs post UPSI
• ellaOne – up to 120hrs post UPSI
• Intrauterine
• Copper IUD

Question 4

describe the three different types of EC including timing, method and efficacy

Answer 4

Levonelle- up to 72 hours after UPSI
, Inhibits ovulation, 1-2% failure rate

EllaOne, up to 120 hrs after UPSI, inhibits ovulation, interacts with antacid, 1% failure rate

Copper IUD, Toxic to Sperm and Ovum, can be used up to 120 hrs after UPSI or 120 hrs after earliest expectated date of ovulation