Unplanned Pregnancy

Question 1

What age group has the highest rates of TOP?

Answer 1

20-24

Question 2

What is the HSA1 (certificate A in Scotland) form?

Answer 2

Two doctors required to sign

Question 3

What is the HSA2 (certificate B in Scotland) form?

Answer 3

To be completed by the doctor within 24hours of an emergency abortion

Question 4

What is the HSA4 form?

Answer 4

Must be completed by the doctor and sent to the CMO within 7 days of the abortion taking place

Question 5

How long is the time from referral to the TOP clinic to treatment?

Answer 5

2 weeks

Question 6

What is the legit limit for social TOP and fetal anomaly?

Answer 6

Social: 23 weeks 6 days
Anomaly: Any gestation

Question 7

How is medical TOP carried out?

Answer 7

1. Oral Mifepristone 200mg
2. 24-48hrs later: vaginal (or oral) prostaglandin e.g. misoprostol, gemeprost
   Early (<9wks)- 2nd part at home
   Late/mid- repeated doses of prostaglandin 3 hourly (max 5/24hours)
   Failed medical may require surgical

Question 8

How is surgical TOP carried out?

Answer 8

Vacuum aspiration 6-12wks

Dilatation and evacuation 13-24 wks (not available in Scotland)

Question 9

What is required for surgical TOP?

Answer 9

Cervical priming- vaginal prostaglandin

Procedure: daycase, GA, electric vacuum aspiration technique, routine USS not required, LARC fitting

Question 10

What are some complications of TOP?

Answer 10

Pain
Haemorrhage
Infection
Incomplete/failed procedure
Uterine perforation*
Cervical trauma*
Anaesthetic complications
Ongoing pregnancy
Uterine rupture

Question 11

What aftercare is required for TOP?

Answer 11

Follow up- usually urine PT at 2-3wks
Anti D
Contraception

Question 12

When can EC be taken?

Answer 12

Levonelle- up to 72hrs post UPSI
ellaOne- up to 120hrs post UPSI
Copper IUD- up to 120 hours post UPSI, or up to 5 days after earliest expected date of ovulation