Unplanned pregnancy and abortion

Question 1

What percentage of pregnancies are unplanned?

Answer 1

20-50%

Question 2

What percentage of unplanned pregnancies lead to abortion?

Answer 2

30-40%

Question 3

For a planned abortion - what must be signed and by who?

Answer 3

certificate A

by two doctors

Question 4

For an emergency abortion - what must be signed and by who?

Answer 4

certificate A

by one doctor

Question 5

What consitutes an emergency abortion?

Answer 5

abortion is needed to save a mothers life

Question 6

What is the most common HSA1 form catagory for abortion?

Answer 6

C - pregnancy has not exceeded 24th week and continuing the pregnancy would cause physical or mental harm to the mother

Question 7

What HSA1 form catagory has no gestational limit?

Answer 7

E - carrying on the pregnancy would mean that the child would be severely handicapped

Question 8

What should be the time period between referral and consultation?

Answer 8

<5 days

Question 9

What should be the time period between referral and procedure?

Answer 9

<2 weeks

Question 10

What is the medical option for termination?

Answer 10

Mifepristone 200mg PO then 24-48hrs later Misoprostol 200mcg PV

Question 11

Where can misoprostol be given if the termination is under 10 weeks?

Answer 11

at home

Question 12

Can those under 16yrs take misoprostol at home?

Answer 12

NO

Question 13

How is misoprostol given if over 10 weeks?

Answer 13

in patient
800mcg to begin with
then 400 mcg 3 hourly

Question 14

Up to how many weeks is medical abortion allowed?

Answer 14

19+6

Question 15

If you are over 19+6 weeks and want a medical abortion, what happens?

Answer 15

you go to England

Question 16

What is the legal limit for termination of pregnancy?

Answer 16

23+6

Question 17

What are the surgical abortion methods for under 14 weeks?

Answer 17

electric vacuum aspiration or manual vaccum aspiration

Question 18

What are the surgical abortion methods for over 14 weeks?

Answer 18

dilation and evacuation - only in england

Question 19

What must you obtain before an abortion?

Answer 19

written consent

Question 20

What are the possible complications of abortion?

Answer 20

haemorrhage
infection
uterine perforation - only surgical 
cervical trauma - only surgical
failed/incomplete abortion

Question 21

What prophylaxis should be given to those undergoing a surgical abortion?

Answer 21

infection = antibiotics
VTE = LMWH (if high risk)

Question 22

Does fertility change after an abortion?

Answer 22

no

Question 23

What contraception can be provided immediately after an abortion?

Answer 23

pretty much them all apart from - diaphragm

Question 24

What follow up is used for abortions?

Answer 24

2 weeks after do a urine pregnancy test - to identify failed or complete procedure

Question 25

What is rape?

Answer 25

penetration of the vagina, anus or mouth by the penis without consent

Question 26

How long can sperm last in the female genital tract?

Answer 26

5 days

Question 27

How long can an ovum last in the female genital tract?

Answer 27

24 hours

Question 28

What are the 3 types of emergency contraception?

Answer 28

progesterone only - Levenogestrel selective progesterone receptor modulator - Ulipristal Copper IUD

Question 29

How does mifepristone work?

Answer 29

enhances uterine activity and increases prostaglandin receptors

Question 30

When can levenogestrel be taken after sex for protection?

Answer 30

up to 72hours - more effective the earlier

Question 31

How does levonogestrel work?

Answer 31

high dose progesterone - so delays ovulation

Question 32

What is the effectiveness of levonorgestrel?

Answer 32

50-100% | must use barrier form of contraception for 7 days after

Question 33

How often can levonogestrel be used in a cycle?

Answer 33

more than once

Question 34

What is the mode of action of Ullipristal?

Answer 34

selective progesterone receptor modulator | delays ovulation and has endometrial effects

Question 35

When can Ullipristal be taken after unprotected sex?

Answer 35

up to 5 days - 90% effective

Question 36

Why must you wait 5 days before starting hormonal contraception after using Ullipristal?

Answer 36

may decrease the effectiveness

Question 37

When is Ullipristal contraindicated?

Answer 37

those on steroids for uncontrolled/acute asthma

Question 38

What is the most effective method of emergency contraception?

Answer 38

Copper IUD

Question 39

How does the copper IUD work?

Answer 39

toxic to the sperm so prevents fertilisation and implantation

Question 40

When can the copper IUD be taken after unprotected sex?

Answer 40

up to 5 days after | nearly 100% effective

Question 41

Why can both the copper IUD and Ullipristal be given up to 5 days after unprotected sex?

Answer 41

pregnancy doesnt implant until day 8-10