Unplanned Pregnancy Flashcards
who has to approve an aborption before it takes place
2 doctors
name the 2 emergency criteria of the abortion act 1967
allow an abortion if:
- it was necessary to save the life of a woman
- it was necessary to prevent grave permanent injury the physical/mental health of the woman
what criterion of the abortion act 1967 is the most commonly used?
C
pregnancy <24 weeks and continuance would involve risk of physical/mental health injury greater than abortion risk to the woman
in a TOP clinic, what is assessed?
competency complete medical history method of abortion USS (STI screen) bloods
why is USS done in TOP?
confirms intrauterine pregnancy
determines gestation
what bloods are done before TOP?
FCS
G+S
(BBV screen)
what is a G+S screen?
checks rhesus factor
checks blood group
what treatment is given before an abortion?
prophylactic antibiotics
NHS Tayside time limit for abortions?
under 19 weeks
NHS Tayside time limit for surgical abortions?
up to 12 weeks
NHS Tayside time limit for medical abortions?
up to 19 weeks
what is classed as an early medical abortion?
up to 9 weeks
what is classed as a late medical abortion?
9-12 weeks
describe the process of a medical TOP including drug and dose
- oral mifepristone 200mg given
2. vaginal/oral misoprostol given 24-48hrs later
what is mifepristone and what does it do?
anti-progesterone to break down the uterine wall
what kind of drug is misoprostol?
synthetic progesterone
how does a late/mid-trimester medical abortion differ?
they are given repeated doses of misoprostol every 3 hours
what is the maximum number of progesterone doses you can take in 24 hours to induce abortion?
5
can mifepristone be taken at home? if yes, what situations?
yes if pregnancy is under 9 weeks
name the 2 types of surgical abortion and when they can be done?
vacuum aspiration: 6-12 weeks
dilatation and evacuation: 13-24 weeks
when can you give a contraceptive in someone who has had a surgical TOP?
straight away, try and do it during the procedure eg inserting an IUD
what drug is given before a surgical TOP and why?
vaginal prostaglandin
to prime the cervix
at what gestation can manual vacuum aspiration be done
up to 9 weeks
procedural risks of TOP
pain haemorrhage infection rupture failed abortion cervical trauma/uterine perforation (surgery)
when is a pregnancy done after TOP?
2-3 weeks
what aftercare should be provided in abortion?
give anti-D within 72hrs
pregnancy test
counselling
contraception
most contraception can be started immediately after TOP T or F
T
what is psychosexual dysfunction?
disturbance of sexual dysfunction that is psychological/emotional in nature
name male examples of psychosexual dysfunction
ED
premature ejaculation
delayed ejaculation
what is vaginismus and what causes it?
involuntary muscle spasms prevent entry to the vagina during sex
- fear of pain of penetration
give examples of triggers of psychosexual problems
postnatal period after gynae problems menopause Hx of abuse menopause
what kind of presentations could suggest the patient could have psychosexual dysfunction?
loss of desire
non consummation
erectile difficulties
avoiding relationships
Tx of psychosexual dysfunction?
drugs
hormone replacement
surgical
physiotherapy
what structure should you use when you present a consultation?
setting referral opening words appearance of patient what were you thinking/feeling
