Unplanned Pregnancy Flashcards
(42 cards)
what percentage of pregnancies are unintended globally?
30-50%
What are the poorer outcomes if an unintended pregnancy is continued?
- Later initiation and less frequent antenatal care
- increased preterm birth and low birthweight
- increased postpartum depression and substance misuse
- reduced breastfeeding rates
- decreased bonding with infant
- increased rates of child neglect and abuse
- poorer long-term developmental outcome
What % of unintended pregnancies end in abortion?
30-40%
How many deaths an hour does unsafe abortion cause?
8
When will abortion law changes in NI come into place?
march 2020
What indication is abortion certified under?
5 clauses A to E
What form is abortion certified on?
HSA1- two doctors sign
How is emergency abortion certified?
Emergency causes- F & G - one doctor signs
Who must be informed about all abortions?
CMO under abortion notification form
What is clause C?
- 98% of abortions are certified under clause C
- gestational limit of 24 weeks
- continuing the pregnancy would involve risk of injury to the physical or mental health of the pregnant women or her existing children/family (greater than if the pregnancy were terminated)
What is the second commonest abortion clause?
E (1-2%)
- no gestational limit
- substantial risk that if the child it were born it would suffer from such physical or mental abnormalities as to be seriously handicapped
When does conscientious objection not apply?
- does not apply in emergency or life-threatening situations
- should not delay or prevent a patients access to care
- does not apply to indirect tasks associated with abortion e.g. administrative, supervision of staff
Who provides the national clinical guidance?
NICE and RCGO
How long should be aimed for between referral and consultations?
<5 days
How long should be aimed for between referral and procedure?
<2 weeks
What age range has the highest rate of abortions?
20-24 years
What are the methods of abortion?
Medical or surgical
What may influence the choice of abortion method?
Gestation
Patient preference
Regional availability
How is the clinical assessment of gestation made?
Estimated by LMP +/- date of +ve UPT
Palpable uterus >12 weeks
How is the ultrasound assessment of gestation made?
Abdominal or transvaginal (<6 weeks)
What medications are involved in medical abortion?
Mifepristone 200mg PO
Misoprostol 800mcg PV/SL (24-48 hours later)
What is the protocol for medical abortion if <10 weeks gestation?
Can self-administer misoprostol at home
What is the protocol for medical abortion if >10 weeks gestation?
Inpatient procedure;
Repeated doses of PV miosoprostol 800mcg PV then 400mcg 3-hourly PV/PO/SL (up to 4)
Describe a surgical abortion
Removal of PoC via surgical procedure under anaesthesia, cervical priming via misoprostol or osmotic dilators
