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1. Reproduction > Unplanned pregnancy and abortion > Flashcards

Unplanned pregnancy and abortion Flashcards

1
Q

What percentage of pregnancies are unplanned?

A

20-50%

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2
Q

What percentage of unplanned pregnancies lead to abortion?

A

30-40%

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3
Q

For a planned abortion - what must be signed and by who?

A

certificate A

by two doctors

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4
Q

For an emergency abortion - what must be signed and by who?

A

certificate A

by one doctor

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5
Q

What consitutes an emergency abortion?

A

abortion is needed to save a mothers life

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6
Q

What is the most common HSA1 form catagory for abortion?

A

C - pregnancy has not exceeded 24th week and continuing the pregnancy would cause physical or mental harm to the mother

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7
Q

What HSA1 form catagory has no gestational limit?

A

E - carrying on the pregnancy would mean that the child would be severely handicapped

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8
Q

What should be the time period between referral and consultation?

A

<5 days

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9
Q

What should be the time period between referral and procedure?

A

<2 weeks

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10
Q

What is the medical option for termination?

A

Mifepristone 200mg PO then 24-48hrs later Misoprostol 200mcg PV

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11
Q

Where can misoprostol be given if the termination is under 10 weeks?

A

at home

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12
Q

Can those under 16yrs take misoprostol at home?

A

NO

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13
Q

How is misoprostol given if over 10 weeks?

A

in patient
800mcg to begin with
then 400 mcg 3 hourly

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14
Q

Up to how many weeks is medical abortion allowed?

A

19+6

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15
Q

If you are over 19+6 weeks and want a medical abortion, what happens?

A

you go to England

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16
Q

What is the legal limit for termination of pregnancy?

A

23+6

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17
Q

What are the surgical abortion methods for under 14 weeks?

A

electric vacuum aspiration or manual vaccum aspiration

18
Q

What are the surgical abortion methods for over 14 weeks?

A

dilation and evacuation - only in england

19
Q

What must you obtain before an abortion?

A

written consent

20
Q

What are the possible complications of abortion?

A 
haemorrhage
infection
uterine perforation - only surgical 
cervical trauma - only surgical
failed/incomplete abortion
21
Q

What prophylaxis should be given to those undergoing a surgical abortion?

A 
infection = antibiotics
VTE = LMWH (if high risk)
22
Q

Does fertility change after an abortion?

A

no

23
Q

What contraception can be provided immediately after an abortion?

A

pretty much them all apart from - diaphragm

24
Q

What follow up is used for abortions?

A

2 weeks after do a urine pregnancy test - to identify failed or complete procedure

25
Q

What is rape?

A

penetration of the vagina, anus or mouth by the penis without consent

26
Q

How long can sperm last in the female genital tract?

A

5 days

27
Q

How long can an ovum last in the female genital tract?

A

24 hours

28
Q

What are the 3 types of emergency contraception?

A

progesterone only - Levenogestrel
selective progesterone receptor modulator - Ulipristal
Copper IUD

29
Q

How does mifepristone work?

A

enhances uterine activity and increases prostaglandin receptors

30
Q

When can levenogestrel be taken after sex for protection?

A

up to 72hours - more effective the earlier

31
Q

How does levonogestrel work?

A

high dose progesterone - so delays ovulation

32
Q

What is the effectiveness of levonorgestrel?

A

50-100%

must use barrier form of contraception for 7 days after

33
Q

How often can levonogestrel be used in a cycle?

A

more than once

34
Q

What is the mode of action of Ullipristal?

A

selective progesterone receptor modulator

delays ovulation and has endometrial effects

35
Q

When can Ullipristal be taken after unprotected sex?

A

up to 5 days - 90% effective

36
Q

Why must you wait 5 days before starting hormonal contraception after using Ullipristal?

A

may decrease the effectiveness

37
Q

When is Ullipristal contraindicated?

A

those on steroids for uncontrolled/acute asthma

38
Q

What is the most effective method of emergency contraception?

A

Copper IUD

39
Q

How does the copper IUD work?

A

toxic to the sperm so prevents fertilisation and implantation

40
Q

When can the copper IUD be taken after unprotected sex?

A

up to 5 days after

nearly 100% effective

41
Q

Why can both the copper IUD and Ullipristal be given up to 5 days after unprotected sex?

A

pregnancy doesnt implant until day 8-10

1. Reproduction (50 decks)

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