induced abortion

-named pregnancy termination .-named pregnancy termination . -two doctor at least should decide -two doctor at least should decide

induced abortion when these are induced abortion when these are greater risk physically & mentally on greater risk physically & mentally on mother & child , also there is risk of mother & child , also there is risk of abnormality .abnormality .

-termination prior to 24 weeks or before -termination prior to 24 weeks or before 20 weeks gestation .20 weeks gestation .

-counseling includes social ,medical , & -counseling includes social ,medical , & psychological aspectpsychological aspect

Methods of termination of pregnancy -screening for STIs & give antibiotic . -anti-D for RH –ve ,after termination . -after termination check physical

&contraceptive measures. -12 % who need termination if does not

given antibiotic can develop PID & c.trachomatis

Surgical termination of pregnancy Most common used in the 1st trimester -use of dilator to open the cervix this

called suction curette -E&C in the second trimester under GA

if 10 weeks or less under local anesthesia to decrease the incidence of hospitalization

Medical termination of pregnancy : -used after 14 weeks gestation instead of

E&C -progesterone antagonist { mifepristone}

given orally then 36-48 hours orally or vaginal pessary ,success rate more than 35 %.

-in the second trimester : vaginal prostaglandin every 3 hours

-extra amniotic infusion –{use of mifepristone through folly catheter fitted in the cervix, then do E&C to remove placenta, remember this procedure need to be client in single room ,with maintenance privacy ,& analgesia .this referred to legal abortion

Complications of termination :

** early complication: Bleeding –uterine perforation –damage

pelvic viscera –cervical laceration –retained product & sepsis-small failure rate

**late complications: -infertility –cervical incompetence –

isoimmunization –psychiatric disease

NB; unsafe abortion one cause of maternal death which lead to septic abortion ( commonly illegal & used in non sterile technique psychological sequelae of termination :

?-fatal abnormality -?pregnancy wanted or not

-?previous diagnosis of the problem -feeling of distress & traumatic

experience -need support from Dr,midwife husband

–family support .

** role of midwife

-primary caring of mother -provide well care to mother -prevent harm -assist in blood test ,& amniocentesis -give advice & necessary information . -ready to care with her in case of

emergency.