Unplanned Pregnancy Flashcards
How many annual unplanned pregnancies occur?
80 million
How many abortions occur annually?
50 million
What are causes of an unplanned pregnancy?
Failure/poor use of contraception
Rape, domestic abuse
trafficking
What age group receive the highest number of abortions?
20-24 year olds
When can an abortion take place?
When two registered medical practitioners are in the opinion that an abortion is justified within the act
What act effects abortions?
The Abortion Act 1967
Where must an abortion take place?
In an NHS hospital or approved place
What form is the HSA1?
Signed by two doctors prior to the abortion
What is the HSA2 form?
Completed by the doctor within 24 hours of an emergency abortion
What is the HSA4 form?
Must be completed and sent to the Chief Medical Officer within 7 days of the abortion
Name 5 issues that would bring about an ethical issue if present in an abortion case
Under 16 Learning disability HIV positive Patient confidentiality Domestic abuse
Can a doctor deny a patient an abortion?
Yes, as long as they refer them to a doctor who will and not in the case of an emergency
How quickly on average should it take for a patient referral regarding an abortion?
2 weeks
What is the legal limit of gestation for a social termination of pregnancy?
23 weeks 6 days
What is the legal limit of gestation for an abortion due to a fetal anomaly?
Any gestation
When would surgical termination be offered in NHS Tayside?
Up to 12 weeks
When would medical termination be offered in NHS Tayside?
Up to 18 weeks and 6 days
What are the time categories regarding a medical termination?
Early - up to 9wks
Late - 12 wks
Mid-trimester - 12-24 wks
What are the stages of a medical termination?
- Oral Mifepristone 200mg (anti-progesterone)
2. 24-48 hrs later - vaginal (or oral) prostaglandin e.g. misoprostol, gameprost
How often can repeated doses can be given in a late/mid-trimester termination?
3 hours (max 5/24 hours)
What are the methods of surgical termination?
Vacuum aspiration - 6-12 wks
Dilatation and evacuation- 13-24 wks
Which method of surgical termination is not available in Scotland?
Dilatation and Evacuation
What is surgical TOP?
Cervical priming using prostaglandin
Electric vacuum aspiration technique
LARC fitting
What is MVA?
Manual Vacuum Aspiration
Newer alternative for early gestation
Can be performed under LA
What are complications of TOP?
Pain Haemorrhage Infection Incomplete/failure uterine perforation Cervical trauma
What should a urine pregnancy test be carried out following TOP?
2-3 weeks
What drugs can be used as emergency contraception?
Levonelle - up to 72hrs post UPSI
EllaOne - up to 120hrs post UPSI
What non drug based technique can be used as an emergency contraception?
Copper IUD
What is the mode of action of Levonelle?
Inhibits ovulation
What is the mode of action of EllaOne?
Inhibits/delays ovulation
What can levonelle interact with?
Enzyme inducers
What can ellaOne interact with?
Antacids
When should a urine pregnancy test be carried out after emergency contraception?
After 3 weeks
What is cheaper, Levonelle or ellaOne?
Levonelle - £5.11
ellaOne - £16.95
When can the copper IUD be used as an emergency contraception?
Up to 120hrs post UPSI
What should high risk women be screened for prior to copper IUD insertion?
STI’s
