Termination of pregnancy

Question 1

Which surgical procedure is carried out for TOP in the 1st trimester?

Answer 1

Suction evacuation (1st trimester)

Question 2

Which surgical procedure is carried out for TOP in the 2nd trimester?

Answer 2

Dilation and evacuation (2nd trimester)

Question 3

Which medical drugs are used for termination of pregnancy before 63 days gestation

Answer 3

Mifepristone 200mg orally

Followed by Misoprostol 800 micrograms PV, Buccal, or Sublingual 24-48 hours later.

Question 4

From 64 days to 13+6 weeks; what drugs are given for termination of pregnancy

Answer 4

Mifepristone 200mg orally

Followed by Misoprostol 800 micrograms PV, Buccal, or Sublingual 24-48 hours later

Followed by Misoprostol 400 micrograms every 3 hours until abortion occurs

Question 5

From 14 weeks gestation, what drugs are given for Medical termination of pregnancy?

Answer 5

Mifepristone 200mg orally

Followed 12-48 hours later by Misoprostol 800 micrograms vaginally

Followed by Misoprostol 400 micrograms orally or vaginally very 3 hours until abortion occurs

If at 24 hours abortion has not occurred, mifepristone can be repeated 3 hours after the last dose of misoprostol

Question 6

What are complications for Termination of Pregnancy?

Answer 6

Failure to end the pregnancy
Need for further intervention (to complete the procedure - ie surgical intervention)
Haemorrhage (requiring transfusion)
Uterine rupture (assocation with second trimester medical)

Question 7

What are the complications for Surgical abortions?

Answer 7

Cervical trauma
Uterine perforation
Further treatment (eg blood transfusion, hysterectomy etc)
Upper genital tract infection

Question 8

What is the law behind abortions?

Answer 8

Abortion Act 1967:
* Under UK law, an abortion can be carried out during the first 24 weeks of pregnancy as long as certain criteria defined in the Abortion Act 1967 are met.
* This act states that a pregnancy may be terminated by a registered medical practitioner, it TWO registered medical practitioners are of the opinion that:
1. The pregnancy has not exceeded its 24th week and that continuance of pregnancy would involve risk, greater than if the pregnancy were terminated of injury to the physical or mental health of the pregnant woman or any existing children of her family; OR
2. The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman; OR
3. The continuance of the pregnancy would involve the risk to the life of the pregnant woman, greater than if the pregnancy were terminated; OR
4. There is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.