Unplanned Pregnancy

Question 1

What % of pregnancies are unintended at the point of conception?

Answer 1

30-50%

Question 2

Up to what gestation can a pregnancy be terminated?

Answer 2

23+6 weeks

Question 3

What gestation limit is put on termination of pregnancies where a significant risk of foetal disability is present?

Answer 3

No gestational limit exists in this scenario.

Question 4

In what scenario must all healthcare professionals assist in abortion?

Answer 4

Emergency/Life-threatening situations.

Question 5

Are abortions safer at a later gestation?

Answer 5

No, earliest is safest.

Question 6

As gestation increases, does the uterus change in sensitivity to abortive medications?

Answer 6

Yes,it becomes more sensitive to mifepristone - a smaller dose can therefore be given.

Question 7

What is the most commonly chosen form of abortion?

Answer 7

Medical

Makes up 97% of cases.

Question 8

How is a medical abortion carried out?

Answer 8

Mifepristone initially then misoprostol 24-48 hours later.

Question 9

Until which gestation can a home abortion be carried out?

Answer 9

11+6 weeks

Question 10

What age group is responsible for most abortions?

Answer 10

20-24 year olds.

Question 11

How is mifepristone given?

Answer 11

Orally

Question 12

What is a potential side-effect of misoprostol treatment?

Answer 12

Fever - beware sepsis.

Question 13

What should be carried out in an abortion in those over 12 weeks gestation?

Answer 13

USS

Perform procedure in clinical setting (regardless of method chosen)

Question 14

Is abortion dangerous?

Answer 14

No, it is a low-risk procedure.

Question 15

What is the most common complication of abortion?

Answer 15

Haemorrhage

Question 16

What is offered to those who opt for a surgical intervention?

Answer 16

Prophylactic antibiotics

Question 17

What antibiotics are given prophylactically in those attending for a surgical termination?

Answer 17

7 days of 100mg doxycycline bd OR 1g azithromycin followed by 0.5g azithromycin bd therafter.

Question 18

What should be given to all rhesus negative women?

Answer 18

Anti-D.

Question 19

Is DVT a risk in those undergoing abortion?

Answer 19

Yes, pregnancy is a hypercoagulable state.

Question 20

What should always be discussed following abortion?

Answer 20

Contraception

Question 21

Is contraception immediately effective following abortion?

Answer 21

Yes, if started within 5 days.

Question 22

Is USS routinely carried out following an abortion?

Answer 22

No

Question 23

What is carried out 2 weeks after a medical abortion?

Answer 23

Low-sensitivity pregnancy test (this is of HIGHER sensitivity).

Question 24

What surgical interventions are available before 14 weeks gestation?

Answer 24

Electric vacuum aspiration (under GA)

Manual vacuum aspiration (under LA)

Question 25

After 14 weeks gestation, what surgical intervention is carried out?

Answer 25

Dilatation and evacuation

Question 26

What is the benefit to using local anaesthetic rather than general anaesthetic for surgery?

Answer 26

Allows for rapid discharge following a procedure.