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Flashcards in Pregnancy term Deck (29):
1

what is abortion law in canada

none - legal by default

2

what is abrotion data

1:4 for live births

3

what is global abortion issue

only half are performed safely
- mostly in areas where it is illegal

4

what is maternal death rate in abortions in africa compared to canada

1000x greater

5

where are abortions done in canada

half clinic, half hosp

6

who gets most abortions

young women
- teens have more abortions that births

7

3 general reasons for abortions

1. social
2. fetal complications
3. maternal complications

8

what age are most done at

9

when does access become an issue

T2 only accessable in some place
- no one doing late term in canadas

10

types of surgical ab in 1st tri (2)

1. MVA
2. suction DandC

11

types of surgical ab in 2nd tri

dilatation and evacuation

12

what is MVA

manual vacuum aspiration - hand held and suck it out
- up to 12 weeks GA

13

what is suction DandC

1. dilate cervix with probe and maybe a softener
2. suck out with a vacuum
up to 16wks GA

14

what is dilatation and evac.

1. osmotic dilators of cervix
2. removal with forceps and suction
up to 23 weeks

15

possible pain mgmt options

1. cervical block
2. oral analgesics
3. conscious sedation
4. general

16

indications for medical abortion

- only up to 8 weeks
- meds
-private
- cheaper
- good follow up required

17

3 main medical options

1. mifipristone and misoprstol - approved
2. methotrexate and misoprostol - only if no mifi
3. misoprotol alone - common in illegal

18

what is mifipristone (MOA)

not available in canada
- anti-progesterone
- alters endo
- induces bleeding
- softens cervix
- induces contractions

19

MOA of methotrexate

- folic acid antagonist
- interferes with trophoblast development

20

MOA of misoprostol

synthetic prostaglandin
- stims. uterine contractions
- induces cervical softening

21

outcomes for metho and miso

90 -

22

which is better - mife or metho

mife

23

what is late term abortion

induction of labor

24

steps for induction of labor

- misoprostol followed by oxytocin
- sometimes pretreat with KCl in fetal heart

25

what are 2 adv. of induction of labor over DandE

1. intact fetus -better patho
2. opportunity to see fetus - grief and closure

26

what is complication rate

minor - 1-5%
major - 0.1-2%

27

3 immediate complications

1. uterine perforation
2. hemorrage
3. cervical laceration

28

3 short term complications

1. pain
2. fever
3. bleeds

29

what is evidence for long term complications

1. breats cancer - none
2. post-abortion syndrome - not good
3. future pregnancy outcomes - conflicting results

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