SM198 Spontaneous and Induced Abortion Flashcards Preview

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Flashcards in SM198 Spontaneous and Induced Abortion Deck (16)
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1
Q

Clinical diagnosis of an abnormal pregnancy

A

Failure to demonstrate an appropriate rise in hCG and to identify an intrauterine gestation by ultrasound

2
Q

What percentage of pregnancies are unintended? What percentage of those end in termination?

A

50%, 50%

3
Q

When do most induced abortions happen?

A

First trimester, <12 weeks

4
Q

What is the risk for death from a uterine evacuation?

A

At 9 weeks gestation or less, 1 in 500k. Very safe. Safer than having a full-term delivery. Second term abortions are a little less safe, 3 in 100k.

Places with restricted abortion access or where abortion is illegal have higher mortality rates. Dropped in the US after Roe v. Wade.

5
Q

Medical abortion

A

Mifepristone: increases uterine sensitivity to exogenously administered prostaglandins, most notably PGE1 agonsists such as misoprostol

Misoprostol: heat stable and inexpensive, leads to expulsion of tissue

Side effects: dizziness, lightheadedness, flu-like symptoms, fever, chills

6
Q

Surgical abortion (D&C): EVA vs. MVA

A

EVA (electrical vacuum aspirator): electric, noisy, not portable, more expensive, continuous suction, bigger capacity

MVA (manual vacuum aspirator): mechanical, quiet, portable, cheaper, variable suction, smaller capacity

7
Q

How do you confirm an abortion is complete?

A

Identification of products of conception (POC)

8
Q

Do you need to wait until after 6 weeks to do an abortion?

A

No, that’s what people used to think, not necessary

9
Q

What type of anesthesia is most commonly used?

A

Local > local + IV > general

10
Q

Medical abortion contraindications

A

Ectopic pregnancy, IUD, chronic steroid use, hemorrhagic disorders, anticoagulant use, adrenal failure, allergy to drugs

11
Q

Medical vs. surgical: success rate

A

Medical: 92-99%

Surgical: 99%

12
Q

Medical vs. surgical: number of visits

A

Medical: 2+

Surgical: 1

13
Q

Medical vs. surgical: procedure time

A

Medical: within 24 hours of second dose

Surgical: 5-10 minutes

14
Q

Medical vs. surgical: anesthesia?

A

Medical: no

Surgical: yes

15
Q

Medical vs. surgical: clinic or at home?

A

Medical: much can be done at home

Surgical: clinic

16
Q

Medical vs. surgical: risks

A

Medical: retained products of conception, infection and bleeding

Surgical: uterine perforation (1/1000), retained products of conception (1%), infection, and bleeding