FPC: family planning Flashcards
(25 cards)
What is an induced abortion?
Termination of pregnancy through pharmacological or surgical means
What is spontaneous abortion?
Pregnancy loss before 20-week gestation
How many women experience abortion?
1 in 4
How many pregnancies result in spontaneous abortion?
1-2 out of 10
What percent of induced abortions are in patients who were using contraceptive methods?
About 50%
What percent of induced abortions occur in people who have had at least one birth?
55%
When do most abortions occur?
In the first trimester! Over 40% occur in the first 6 weeks
What percentages of abortions occur in the first trimester?
94%
Describe abortion methods in the first trimester.
Usually with abortion pills at home, but procedural, D and C, suction abortion, manual vacuum aspiration also possible
Describe methods of abortion in the second trimester.
Medications can be used but it needs to be an ‘induction abortion’ aka in the hospital, D and E/procedural abortion
Describe medication abortion.
Use of mifepristone and misoprostol cause separation of pregnancy from endometrium and expulsion through the cervix; in the second trimester it will also involve ripening of the cervix and contractions
Describe procedural abortion.
Dilation of the cervix and medical evacuation of intrauterine contents; use of instruments changes depending on trimester due to different fetal tissue growth and placental attachments
How long can placenta/fetal contents remain in the uterus without passing after abortion before we intervene?
4 weeks! There is a risk of DIC after this
Describe mifepristone.
Progesterone receptor antagonists that soften the cervix, helps the placenta separate, promotes contraction, and increases prostaglandin sensitivity
Describe misoprostol.
PGE1 analogue that promotes uterine contraction to expel fetal tissue
What changes as far as medication abortion between first and second trimester?
Higher dose of misoprostol second trimester
How does mifepristone impact medication abortion?
It acts as a primer and makes misoprostol much more effective!
What are potential complications of abortion?
Hemorrhage, cervical lacerations, uterine perforation, infection, retained tissue, ongoing pregnancy
What is the death rate of legal pregnancy termination?
0.56 per 100,000
What is the death rate for miscarriage?
1.19 per 100,000
What is the death rate for live births?
32.9 per 100,000
What is the death rate for ectopic pregnancy?
31.9 per 100,000
What is the complication rate for abortions?
0.5%
What are risks of first trimester procedural abortion?
Negligible risk of infertility, future miscarriage, or other long-term problems. Possible, but really never happens.
