Womens Health H&S Flashcards
(169 cards)
1
Q
sex vs gender
A
Sex = male or female (purely biological)
● Gender = determined by social and cultural beliefs, rather than biological
2
Q
cervical cancer RF
A
> Smoking
IC - HIV, tranplant
HPV infection
3
Q
Endometrial cancer RF
A
> Obesity, T2D, HTN - assoc w increased peripheral oestrogen
anvoulatory cycles
early menarche/ late menopause
genetic e.g. HNPCC
4
Q
Which type of HRT increased endometrial cancer risk
A
oestrogen only
5
Q
ovarian cancer RF
A
- Age
- early menarche late menopause
- genetics - BRCA1/2
- Hormonal - use of fertility drugs
6
Q
Vulval cancer RF
A
- VIN
- lichen sclerosus
- HPV
- pagets disease
7
Q
nhs cervical screening programme
A
> 25-49 years old every 3 years
- 50-64 years old every 5 years
- Annual if HIV+
8
Q
exceptions to the routine cervical screening programme
A
> virgins
symptoms of cancer -> ref urgently
prev history of CIN -> more freq surveillence
9
Q
when to reschedule a smear
A
- Currently menstruating
- Less than 12-weeks post-natal
- Current pelvic infection
10
Q
what does a smear actually look for
A
cells tested for high risk HPV - if positive examined with cytology
11
Q
purpose of cervical screening
A
To detect dyskaryosis (pre-cancerous cells)
● Detects squamous cell carcinomas, but not adenocarcinomas (15% of cervical cancers)
12
Q
process of screening for cervica; cancer
A
Assess for HPV 2. Cytological testing (liquid based cytology preferred over Pap smear) 3. Colposcopy (i.e. cervical biopsy)
13
Q
negative HPV test result
A
> V → routine recall (i.e. 3 or 5 years, depending
on age) unless:
○ Test of cure (6 months after treatment)
○ Untreated CIN I (follow up and monitoring)
14
Q
positive HPV test result
A
do cytological testing to look for dyskaryosis
15
Q
if abn on cytology then do
A
colposcopy and biopsy - LEETZ or loop
16
Q
HPV +ve but -ve cytology →
A
repeat HPV at 12m
17
Q
HPV +
A
> if negative cytology rep at 12 m
at 12 months if now HPV - -> return to normal recall
If repeat is still HPV +ve and cytology is still -ve
→ further repeat HPV at 12 months
○ If HPV -ve at 24 months → return to normal
recall
○ If HPV +ve at 24 months → colposcopy
18
Q
inadequate sample then
A
Repeat smear within 3 months. If 2 consecutive inadequate samples → colposcopy.
19
Q
how much has incidence of CC reduced by
A
0.43
20
Q
cancer MDT fundction
A
- Discuss all new diagnoses
- Decide on management plan and inform primary care
- Develop guidelines
- Designate specialist nurse topt
- Audit
21
Q
components of antenatal screening
A
Foetal anomalies
2. Maternal pre-existing issues (e.g. infection)
3. Maternal obstetric complications (e.g. pre-eclampsia)
22
Q
benefits of antenetal screening
A
> Gives women/parents more information about raising children with significant health problems or to
terminate the pregnancy
pre-planning for challenges/ adaptations required
reassurance to low risk women
23
Q
risks of antenetal screening
A
> Only a screening test hence a negative result does not guarantee child won’t have a congenital syndrome
for example
- Risk of diagnostic testing - miscarriage of an otherwise healthy baby could occur
24
Q
Screening for chromosomal abn
A
- 11-13+6 week screen
- estimates risk of downs, edwards and patau
- combined test st (NT, free b-hCG, PAPP-A, maternal age)
25
if high risks what further tests can be done for chromosomal abn
○ Chorionic villus biopsy (10-13 weeks)
○ Amniocentesis (>16 weeks)
○ Features on US (20+ weeks)
26
antenetal screening offered to all women:
Anaemia
● Bacteriuria
● Blood group, rhesus status and anti-red cell antibodies
● Down’s syndrome
● Foetal anomalies
● Hepatitis B
● HIV
● Neural tube defects
● Risk factors for pre-eclampsia
● Syphilis
27
which screening is not offered antenatally
Bacterial vaginosis
● Chlamydia
● CMV
● Fragile X
● Hepatitis C
● Group B Streptococcus
● Toxoplasmosis
28
folic acid supplementation
> 400mg from 3 months prior to conception -> 12 weeks gestation
> 5mg/day if high risk
29
High dose folic acid - indications
Hx of NTD
■ Have a child affected
■ Either partner affected
■ FHx
○ Mum on anti-epileptics
○ Mum has comorbidity
■ Coeliac disease
■ Diabetes
■ Thalassaemia trait
■ Sickle cell
○ Maternal obesity (BMI >30)
30
vitamin d supplementation in pregnancy
10 micrograms (400 units) per day throughout pregnancy and breastfeeding ● For foetal bone formation
31
vitamin A
TERATOGENIC - found in liver
32
iron screeninf
Only if anaemic. Mx with oral iron therapy.
● Screen at:
○ Booking visit (8-10 weeks)
○ 28 weeks
33
antenetal care Tx
- 10 antenatal visits in a 1st & uncomplicated
pregnancy
● 7 antenatal visits in subsequent pregnancies if
uncomplicated
● No consultant required if uncomplicated
34
Booking visit
> ideally 10 weeks, 8-12 weeks
> identifies women who require additional support
> Hx, lifestyle, folic acid
35
tests done in booking
● BP, urine dipstick, check B
36
blood tests done at booking
● FBC, blood group, rhesus status, red cell
alloantibodies, haemoglobinopathies
● Hepatitis B, syphilis
● HIV test is offered to all women
● Urine culture to detect asymptomatic bacteriur
37
12 week scan
done between 10 - 13+6 weeks, confirms dates and excludes multiple pregnancy
38
when is the anomaly scan
20 wks
39
downs syn drome scan
11-13+6 weeks
40
when is first dose of anti D prophylaxis given
28 weeks
41
second dose of anti D
34 WEEKS
42
when should ECV be offered
36 weeks
43
Antenetal lifestyle advice
- stop smoking - Don’t offer Bupropion or Varenicline
● Prevent listeriosis - avoid unpasteurised milk,
ripened soft cheese, pate
44
FGM act 2003
> FGM is illegal in the UK
> It is a criminal offence for UK nationals or permanent UK
resident to take their child abroad for FGM
- Offence to aid, abet or facilitate a non-UK national to carry
out FGM overseas
- Must be reported to police if <18 years old
> Labioplasty is exempt if done to safeguard a woman’s
physical/mental wellbeing
45
how many cycles of IVF are offered
3
46
IVF criteria
- women under 40
- Have been trying to get pregnant through regular unprotected sex for 2 years OR
- Have not been able to get pregnant after 12 cycles of artificial insemination with at least 6 of the cycles using a method called IUI
- Additional criteria may include not having children already, being a healthy weight, not smoking, falling into a certain age range (some CCG groups only treat women under 35)
47
IVF in women over 40
- If you turn 40 during treatment, the current cycle will be completed but further cycles shouldn’t be offered
- Women 40-42 may be offered 1 cycle ofIVF on the NHS if all the criteria are met (been trying to get pregnant for 2 years, never had IVF before, show no evidence of low ovarian reserve, they have been informed of the additional implications of IVF and pregnancy at
this age)
48
DV includes
Coercive control - a pattern of intimidation, degradation, isolation and
control with the use of threat or physical or sexual violence
- Psychological and/or emotional abuse
- Physical abuse
- Sexual abuse
- Financial abuse
- Harassment
- Stalking
- Online or digital abuse
49
RF for DV
> Serious levels of violence before pregnancy
- Feelings of inadequacy
- Jealousy and controlling behaviour
- Partner IV drug abuse
- Low social class
- Poor education
- Social deprivation
50
Alerts for domestic violence/ abuse
- Late booker/poor attender
- Repeat minor injury attendance
- Unexplained admissions
- Depression/anxiety/self-harm
- Injuries of different ages
- STD/UTI/Vaginal infections
- Poor obstetric hx
- Domineering partner
51
stillbirth=
Death of a baby before or during birth after 24 weeks of gestation in the UK
52
stillbirth rate =
: Number of stillbirths per 1000 total births
53
neonatal death =
: Death of a baby in the first 28 days of life. Neonatal death rate = number of neonatal deaths per 1000 total births
54
perinatal mortality=
stillbirths plus early neonatal deaths (under 7 days)
55
maternal mortality =
: Death of pregnant woman or within 42 days of delivery, miscarriage or termination, providing the death is associated with pregnancy or its treatment
56
causes of maternal death UK
- Cardiac disease
- Neurology
- Thrombosis/thromboembolism
- Haemorrhage
- Suicide/psychiatric causes
57
Donabedian’s three components for measuring quality of care
Structure. Process, outcome
58
Donabedian - structure
(staff:patient ratio, operating times of service)
59
donabedian - process
(length of time a pt waits for senior clinician review, staff hygiene, recording of incidents)
60
donabedian - outcome
(length of stay, mortality, incidence of hospital acquired infections, adverse incidents/harm, emergency admissions, patient experience)
61
public health issues for the control of infection
- hand hygiene
- sterilisation
- effective waste disposal
- vaccination
- abx resistance
- MRSA screening
62
syphilis pathogen
Treponema pallidum - enters BS through skin or mucous membrane
63
most sypholis cases occur in
MSM, cases increasing in men and decreasing in women
64
phases of syphilis
Primary phase followed by secondary phase followed by latent phase and finally tertiary phase (CVS,
neurosyphilis or gummatous syphilis)
65
first line in syphilis
Pencillin 1st line (in early syphilis beware of Jarisch-Herxheimer reaction - acute febrile illness with headache, myalgia and rigors which resolves in 24 hrs)
66
pathogen in gonorrhoea
Neisseria gonorrheae gram- diplococcus i
67
gonorrhoea in babies
: b/l acute conjunctivitis <48 hours after birth (can cause ophthalmia neonatorum and pneumonia)
68
first line in gonorrhoea
Treated with cefixime IM or cefotaxime IM single dose first line
69
most common STI
Chlamydia
70
most preventable cause of interfility wordwide
chlamydia
71
most consistent RF for chalmydia
young age
72
tx of chlamydia
Treat with doxycycline BD 7/7 or single dose azithromycin
73
HSV1 vs HSV2
> HSV1 is oral, causes cold sore (herpes labialis)
- HSV2 is genital - affects penis, anus and vagina
74
herpes is most common in
2x as common in women, more prev in 20-24 yrs
75
RF for herpes
female and HIV
76
Tx of herpes
Treat by advising saline bathing, topical lidocaine and follow-up appointment, acyclovir not recommended as standard as can cause resistant strains of HSV
77
Genital warts are caused by
HPV 6 and 11, 16 and 18 high risk of CIN
78
hpv warts
usually painful but may itch burn or bleed
79
where do pubic lice live
coarse hair - eyelashes, abdo, back, axilla, head
80
how is pubic lice tx
Treat with insecticide (malathion or permethrin), treat bed linens and increase personal hygiene, screen for other STIs
81
pres of HIV
: asymptomatic for years, persistent generalised lymphadenopathy, symptomatic infection (fever, night sweats, diarrhoea, weight loss) before becoming AIDS
82
Aids definiing conditions
- candidasis of bronchi, trachea, lungs
- kaposis sarcoma
- cryptococcus
- CMV
83
Everyone should be offered and recommended HIV (and other common STIs) testing when attending:
- GUM/ sexual health clinic
- antenatal services
- TOP services
- Drug dependency programmes (or anyone who reports IV drug use)
- Diagnosis of TB, HBV, HCV, lymphoma
- All men and women known to be from a country of high prevalence
84
Testing for HIV at GUM clinic
contact tracing for anyone testing HIV+, All MSM
(annually), all female sexual contacts of MSM, all contacts of anyone from countries with high
prevalence
85
who is HIV routinely tested in
- Blood donors
- Dialysis pts
- Organ transplant donors and recipients
- Needlestick injury workers
86
nutrition advice for pregnancy
> Nutrition (specifically five-a-day, plenty of milk to raise iron vitamin and calcium stores)
- Avoid uncooked meat and fish, unpasteurised milk, soft cheeses and unwashed fruit and veg (due to dangers of toxoplasmosis
and listeriosis)
87
what should be avoided in T1
If women exercise regularly continue this - 1st trimester there is risks to the foetus of overheating so avoid strenuous exercise, saunas and hot tubs
88
When should sexual intercourse be avoided
if there is evidence of PROM
89
seatbelt use in pregnancy
(above and below the bump rather than across)
90
what is bowens disease associated w
Bowen’s disease caused by UV exposure and often associated with HPV 16 and 18 and also arsenic and radiation exposure
91
who is Bowens disease more common in
caucasions living in areas of high sunlight, more common in women
92
what is actinic keratosis assoc w
typically occurs in individual >50 yrs old with light skin (UV induced)
93
actinic keratosis and bowens disease increase risk of
SCC
94
Non melanoma skin cancer rates
increased by 170% - (attributable to excessive UV radiation exposure from artificial sun lamps and
foreign travel
95
85% of skin cancers in the UK are attributable to
excessive exposure to sunlight
96
most common type of skin cancer
> basal cell then sq cell
97
sun behaviours - advice
- Protect skin with adequate clothing, choosing sun protective clothing (if you have fair skin or many moles)
- Wear a hat that protects your face, neck, ears and a pair of UV protective sunglasses
- Spend time in the shade between 11am and 3pm when the sun is at its brightest
- Step out of the sun before your skin has a chance to redden or burn
- Use high SPF sun-cream (SPF 50 or 50+) to protect against UVB and ensure the UVA rating is 4-5 stars
- Apply plenty of sun cream 15-30 minutes before going out in the sun and reapply every 2 hours and straight after swimming and towel drying
- Keep babies and young children out of direct sunlight
98
Melanoma ref ceriteria
- Refer people using the suspected cancer 2ww pathway for melanoma if they have a suspicious lesion with a weighted 7-point checklist score of 3 or more
- Major features: change in size, irregular shape, irregular colour - 2 points each
- Minor features - largest diameter 7mm+, inflammation oozing, change in sensation - 1 point
99
SCC ref criteria
Use the 2ww referral pathway for people with a skin lesion that raises suspicion of SCC (highly variable appearance but often with associated ulceration or bleeding in a lesion that does not go away)
100
BCC ref criteria
Use the 22 referral pathway for people with a skin lesion that raises suspicion of BCC (slow growing pearly white/pink/skin-coloured/pigmented plaque/nodule with telangiectasis +/- rolled border)
101
arguments for assisted reproductive tech
- Procreative autonomy
- Equity – justice
- Child welfare in the case of pre-implantation genetic diagnosis – non-maleficence / beneficenc
102
arguments against reproductive tech
- destruction of human embryos
- Harmful to those trying to conceive (emotional trauma of loss, as only 30% success)
- Unnatutural
- economic crisis
103
Human Fertilisation and Embryology Authorit
= statutory body that regulates and inspects all clinics in the United Kingdom providing IVF, artificial insemination and the storage of human eggs, sperm or embryos. It also regulates human embryo research
104
abortion act 1967 (ammended 1990)
“Person not guilty of an offence…when pregnancy is terminated by registered medical practitioner, if two practitioners are of the opinion, formed in good faith”
105
Criteria for an abortion
- Pregnancy not 24+ weeks, and continuation would involve risk (of injury to physical/mental health of woman/existing kids) greater than that of termination
- Termination >24 weeks if necessary to prevent grave permanent injury (physical/mental), including saving mothers life
- Substantial risk that child, when born, would suffer serious handicap (due to physical / mental abnormalities)
106
under 16 abortion
If < 16 can still have without parental consent if 2 doctors agree = remain confidential regardless of age
107
Conscientous objection to abortion
Can choose to opt out of providing a procedure, because of personal beliefs + values, as long as it doesn’t discriminate against / harass individual patients or
patient groups
B. Tell patient they have right to discuss with another practitioner who doesn’t offer treatment, and refer them or give sufficient info so they know who to
approach
108
against abortion arguments
- morally wrong - fetus has moral status of person
- doing harm = non malificence
- medical comps later in life = physical and psych
109
pro abortion argument
- saves life of mother
- mother has autonomy
- banning will encourage use of unsafe methods = benificence
- Women should be able to avoid the emotional harm of bearing a child by rape = non-malifcence
-
110
Validity vs sound
- Validity – assuming the premises are true, does the conclusion follow logically?
- Sound – are the premises of the argument actually true
111
types of fallacy - straw man
– misrepresenting someone's position so you can reject it easil
112
fallacy - ad hominem
criticising the argument on the basis of who makes i
113
fallacy appealing to emotion
its wrong bc it feels wrong
114
fallacy - beg the question
– presupposing as true what the argument is trying to show is false (or vice versa) and from there concluding the argument must be unsoun
115
fallacy - argument from fallacy
– inferring a conclusion that is false because the argument is invalid or unsoun
116
euthanasia vs assisted suicide
> euthanasia - Deliberately ending a persons life to relieve suffering
• Assisted suicide is deliberately assisting or encouraging another to commit suicide
117
active vs passive euthanisia
- Active does the act of ending life
- Passive withholds life-prolonging treatment = patient can consent to this & make advanced directives to refuse t
118
voluntary, involuntary and non voluntary euthanasia
3. Voluntary when person dying consent
4. Non-voluntary when person dying can’t consent, so make decision for them, often based on statement of wishes
5. Involuntary against persons wishes =
119
arguments for euthanasia
> autonomy over own body and death
> acts in benficence of pt - shortens suffering
120
arguments against euthanasia
> religious
> violates non malifence
> detracts from instead improving end of life care
121
what is the doctrine of double effect
- Says that if doing something morally good has a morally bad side-effect it's ethically okay to do it providing the bad side-effect wasn't intended. This is true even if you foresaw that the bad effect would probably happen
- Used to justify the case where a doctor gives drugs to a patient to relieve distressing symptoms even though they know doing this may shorten the patient's lif
122
criteria of the doctrine of double effect
- good result must be achieved independently of the bad one
- action must be prop to cause
- action must be appropriate
- pt must be in terminal condition
123
what is teen preg assoc w
Associated with lower birth weight and higher incidence of infant mortality
• Teenage mothers experience social problems after - ↓education, ↓in work, ↑poverty poorer outcomes for both mother and chil
124
what has been published to prevent teen pregnancy
Teenage pregnancy prevention framework 2018 = = high quality relationships + sex education (RSE), accessible + friendly youth services providing contraception
125
all perinatal and maternal deaths are reported to
MBRRACE-UK
126
Causes of maternal mortality
- direct 33% - main cause is VTE
- indirect 66% - cardiac disease is the main cause
127
most deaths in which year of life
most deaths in children occur in 1st year
128
infant mortality trends
1. Higher rates in ethnic minority groups
2. Higher rates in teenage & >40 mothers
3. Higher rates in lower socioeconomic groups
4. Reduced risk with second baby & reducing with
129
# BIGGEST RF
RF for stillbirth
- FGR - biggest
- congenital abn
- multiple pregnancy
- extremes of age
- low SES
- ethnicity
130
which age gr gets most STIs
15-24yr
131
Hiv groipds
Number of heterosexual infections is increased but homosexual males still account for
the HIGHEST PREVALENCE = incidence now lower than heterosexual, but still most
prevalen
132
are Diagnosis of HIV and refuse to tell p
r:
1. Attempt to convince to tell
2. Doctor has duty of care to both patient & partner
3. Doctor has duty of confidentiality
4. Don’t have to inform seek advice from GU
consultant / medical defense & inform patient = may
get sued if don’t tell them
5. If believe partner is at high risk can tell them (tell
patient
133
prevention of HIV
- Consistent condom use
- IVDU and needle exchange
- control other STIs
- effect post exposure prophylaxis
- HIV mothers not breastfeeding
- promote prevention in highest risk populations e.g. Black African
134
CQC
- The CQC regulates and inspects healthcare providers to ensure safe, effective, and high-quality care.
- Providers are rated based on domains such as safety, effectiveness, and patient experience.
135
maternity and gynaecology dashboards
- Used by NHS England to track key performance indicators (KPIs), such as:
- Maternal mortality rates.
- Cesarean section rates.
- Patient satisfaction surveys in women’s services.
136
PHE
Publushes health profiles with statistics on CC screening uptake, comtraception access, Maternal health
137
NHS long term plan - maternity
Aims to improve maternity services, increase breastfeeding rates, and enhance postnatal care.
138
Who has resp for comissioning sexual health services
local authorities and NHS England
139
How are GUM clinics accessed
self referral or GP referral
140
what do GUM clinics do
Comprehensive STI testing.
HIV management (in collaboration with infectious disease departments).
141
funding and commissioning of services
> : The Department of Health and Social Care (DHSC) develops national strategies for women’s health.
> comissioned by NHS England for specialist services - tertiary materniry services, gynaecology oncology
142
how are congenital abn tracked
National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).
143
IVF success rates tracked by
Human Fertilisation and Embryology Authority (HFEA).
144
# number of cycles offered
Cycles of IVF
- Women under 40 years: Up to 3 cycles if subfertility is diagnosed or after 2 years of failed natural conception.
- Women aged 40–42: One full cycle of IVF, if specific criteria (good ovarian reserve, no previous IVF) are met.
145
Postcode lottery
Eligibility and the number of funded IVF cycles vary widely across ICBs. For example:
Some areas may only fund one cycle, while others fund up to three.
146
Women under 40 - IVF
Eligible for up to 3 full cycles of IVF if:
The couple has been trying to conceive naturally for at least 2 years or
They have not conceived after 12 cycles of artificial insemination (6 of which must be intrauterine insemination).
147
duration of infertility for IVF
Couples must demonstrate 2 years of regular, unprotected intercourse without achieving pregnancy (unexplained infertility).
148
when do many NHS ICBs not fund IVF
Either partner has a biological or adopted child from a current or previous relationship.
149
women must typically have a BMI of between
19-30 for IVF
150
Smoking status and IVF
Both partners must be non-smokers or commit to quitting smoking before treatment.
151
welfare of the future child assessment
- human fertilisation and embryology act 1990 obliges fertility clinics to assess the potential welfare of the child born as a result of treatment.
- clinics must consider if the intended parents will provide a supportive and safe environemnt
152
factors considered in WOTC assessments
- physical and MH conditions that would impair care for the child
- lifestyle - drugs, smoking
- relationship stability
- legal/ ethical - history of abuse
153
right to family life vs welfare of the child
Balancing the parental right to access fertility treatment with ensuring the best interests of the future child is a delicate ethical issue.
154
Disclosures w/o consent
Disclosure to third parties (e.g., parents, partners, authorities) can occur when:
There’s a serious risk of harm to the patient or others (e.g., if a patient with HIV knowingly exposes others to infection without informing them).
It is required by law (e.g., court order or notification of certain infections like gonorrhea to public health authorities).
155
Care for minors (under 16)
> assess Gillick Competence
> Parental involvement is encouraged where appropriate, but confidentiality must be respected if the minor requests it and is deemed competent.
156
Learning difficulties & consent
> assess capacity
> safeguarding - if signs of abuse, coercion, exploitation
157
suspected rape/ abuse ->
refer along safeguarding guidelines
158
HIV and disclosure
It is not mandatory to inform a sexual partner of HIV status, but patients are encouraged to do so to reduce transmission risk.
159
who is an adult at risk
> has care and support needs
> is experiencing or at risk of abuse or neglect
> as a result of needs, is unable to protect themselves from abuse or neglect
160
Safeguaridng process
> inform the person b4 referring to LA
> if they don't want a safeguarding concern expore other ways of engaging them - if they have capacity w MCA we have to respect this unless other conditions are met
161
safeguarding - you should report all concerns with or without consent if you think there is
- Risk to children/other adults at risk
- Organisational abuse
- Abuse perpetrated by an employee
- Abuse happened on property owned or operated by an organisation providing care
- Relevant to criminal investigation
- Serious harm or threat to life
- wider public interest e.g. fire risk
162
risk assessment for DV
DASH
163
MARAC
> high risk of domestic abuse - high risk of domestic homicide
164
alerts to DV in pregnancy
Late booker/poor attender
Repeat minor injury attendance
Unexplained admissions
Depression/anxiety/self harm
Injuries of different ages (minimalisation)
STD/UTI/vaginal infections
Poor obstetric history
Domineering partner
165
HFA - child welfare
documented procedures to ensure proper acount is tajen of welkfare of any hild who may be born as a result of Tx
166
HFA - RF neflect or sig harm to existing child ot to be born child
> Past or current circumstances that may lead to any child experiencing serious physical or psychological harm or
neglect,
2. Previous convictions relating to harming children
3. Child protection measures taken regarding existing children, or violence or serious discord in the family environment
4. Past or current circumstances that are likely to lead to an inability to care throughout childhood for any child who
may be born, or that are already seriously impairing the care of any existing child of the family, for example;
a. mental or physical conditions,
b. Drug or alcohol abuse.
c. Medical history, where the medical history indicates that any child who may be born is likely to suffer from a
serious medical condition,
d. Circumstances that the centre considers likely to cause serious harm to any child mentioned above.
167
Welfare of the child-HFEA
How Often Should the Unit Request the Information From The GP
- There has been a gap of two years or more in contact between the clinic and the patient(s)
- There has been a change of partner
- A child has been born to the patient(s) since the previous assessment
- Where the Unit has reason to believe that there has been a significant change in the patient’s medical or social circumstances
168
what triggers a more indepth welfare of the child assessment
- comments made by GP
- single woman requesting Tx
- surrogacy
- history of criminal convinctions, drug abuse, mental illness under the care of a pschiatrist
169
HFA - should refuse Tx if
> concludes that any child who may be born or any existing child of the family is
likely to be at risk of significant harm or neglect, or
Cannot obtain enough information to conclude that there is no significant risk.
