Abortion Basic Info | Western Sydney University

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

105

Pages:

5
Author:

Mariam A. A.

Abortion History and Investigations Confirm name and age Reasons behind decision Have you thought about other alternatives? Gynaecological history Date of LMP Regularity Pain Clots Amount Age of menarche Obstetric history Planned or unplanned Spontaneous or induced Any complications so far? Any previous pregnancies? It yes: How many Complications Mode of delivery Birth weight and health Planned vs unplanned Spontaneous vs induced Medical history Medications Surgical Allergies Family history CST screening STI screen Sexual history Number of partners, gender of partners, protected sex, STIs Available options Medical management Mifepristone followed by misoprostol 36 to 48 hours after Advantages Non-invasive and avoids anaesthesia, can also be done at home Risks: Cramping Bleeding Nausea and diarrhoea Incomplete abortion -> retained products of conception Rarely heavy bleeding that would require intervention Can offer antiemetics and analgesia If incomplete abortion can be offered surgical evacuation or repeating misoprostol dose or expectant management. Surgical management Given GA -> vacuum aspiration (suction curettage) Manual evacuation and electric vacuum are both suitable options for surgical aborptions . This would be the preferred due to gestational age Short procedure oxytocin will be used to contract the uterus during the procedure Cervical preparation will be required -> misoprostol vaginally at least three hours prior This is needed for reducing risk of: Incomplete abortion Ongoing pregnancy Future cervical insufficiency Preterm birth And need for additional mechanical dilation measures Doxycycline 100 mg orally 6 hours prior to procedure and 200mg orally after the procedure Benefits Quick, predictable and complete Involved risks: Advice for the Future Contraceptive counselling Should be offered at time of surgical and medical abortion as soon as the pregnancy has been expelled.