Termination of pregnancy Flashcards
What acts cover termination of pregnancy
1967 abortion act
1990 human fertilisation and embryology act - reduced from 28 to 24 weeks
When can a woman get an abortion
When before 24 weeks and continuing pregnancy involves greater risk to physical or mental health of
-woman
-existing children of family
Clinical judgement of medical practitioners
When can an abortion be performed at any time
Continuing pregnancy likely to risk life of woman
Terminating pregnancy will prevent ‘grave permanent injury’ to physcial or mental health of the woman
‘Substantial risk’ that child would suffer physical or mental abnormalities making it seriously handicapped
Legal requirements for abortion
Two registered medical practitioners must agree to sign
Carried out by registered medical practitioner in NHS hospital or approved premise
Pre-abortion services
-Self referral- marie stopes UK
-GP
-GUM
-Family planning clinic referral
-Counselling and information
What do marie stops offer
remote consultation and issue of medication for less than 10 weeks gestation
What does medical abortion involve
Mifepristone - anti-progesteren
Misoprostol - prostaglandin analogue - 1-2 days later
What is mifepristone
Aanti-progestrogen medication blocks action of progesterone, halting preganncy and relacing the cervix
What is misoprostol
Prostaglandin analogue
Binds to prostaglandin receptors to activate them
What do prostaglandins do
Soften cervix and stimulate uterine contractions
What is required after 10 weeks gestation medical abortion
Additional misoprostol doses eg every 3 hours until expulsion
When should rhesus negative women receive anti-D prophylaxis with abortion
> 10 weeks gestation with medical abortion
ALWAYS if surgical (considered if <10 weeks)
How can surgical abortion be performed
Cervical dilation and suction of uterus contents - up to 14 weeks
Cervical dilatation and evacuation using forceps - 14-24 weeks
What is used for cervical priming before TOP surgery
Misoprostol, mifepristine, osmotic dilators
How long can vaginal bleeding and cramps last after procedure
Up to 2 weeks
