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30 Cards in this Set
- Front
- Back
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UNDERSTAND DIFFERENCES BETWEEN SPONTANEOUS & INDUCED ABORTION
KNOW THE HISTORY OF INDUCED ABORTION LEARN INDICATIONS FOR THERAPUETIC ABORTIONS LEARN PROCEDURE TECHNIQUES & COMPLICATIONS KNOW DRUGS USED IN MEDICAL INDUCTION OF ABORTION |
LEARNING OBJECTIVES
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ABORTION IS THE TERMINATION OF PREGNANCY EITHER SPONTANEOUSLY OR INTENTIONALLY BEFORE FETUS CAN SURVIVE ; BEFORE __ WKS OR <____GM
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BEFORE 20 WKS OR <500GM
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Important***
If pt comes in with threatened spontaneous abortion, what are your options? |
THERE ARE NO EFFECTIVE THERAPIES
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TYPES of spontaneous abortion – THREATENED, INEVITABLE, INCOMPLETE, COMPLETE, & M_____
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MISSED
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~____ THOUSAND LEGAL ABORTIONS REPORTED IN 2000
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850
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What's a missed abortion?
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gestational sack starts,
perhaps a fetal pole develops perhaps a heat beat, and then everything stops. Must empty uterus surgically |
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What's a complete abortion?
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Pt presents with a bloody sac of something that she passed while having cramps.
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MAJORITY UNDER AGE __, CAUCASIAN, & UNMARRIED; 60% WERE DONE DURING 1ST 8 WKS , 88% DURING 1ST 12 WKS.
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25
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STRICT ANTI-ABORTION LAWS BEFORE 19__
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1973
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ABORTION BEFORE Q_______ WAS EITHER LAWFUL OR TOLERATED IN U.S. & ENGLAND UNTIL 1803
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QUICKENING
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IN U.S., the state of _________ ENACTED 1ST ABORTION LAW IN 1821. REST OF STATES FOLLOWED
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CONNECTICUT
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INDICATIONS FOR THERAPUETIC AB
1- PERSISTANT HEART DISEASE AFTER CARDIAC D________ 2- ADVANCED H_________ VASCULAR DISEASE 3-INVASIVE CARCINOMA OF THE C_________ |
1- PERSISTANT HEART DISEASE AFTER CARDIAC DECOMPENSATION
2- ADVANCED HYPERTENSIVE VASCULAR DISEASE 3-INVASIVE CARCINOMA OF THE CERVIX |
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IN ADDITION TO MEDICAL & SURGICAL INDICATIONS
1-CASES OF RAPE OR INCEST 2-PREVENT BIRTH OF FETUS WITH SIGNIFICANT ANATOMICAL OR MENTAL D_______ |
DEFORMITY
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_________(type of) ABORTION -- AT THE REQUEST OF THE WOMAN BUT NOT FOR IMPAIRED MATERNAL HEALTH OR FETAL DISEASE
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ELECTIVE OR VOLUNTARY
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How many ELECTIVE TERMINATION? FOR EVERY 4 LIVE BIRTHS?
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1
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COUNSELING – 3 CHOICES AVAILABLE TO PREGNANT WOMEN
1-CONTIN. PREGNANCY WITH IT’S RISKS & MATERNAL RESPONSIBILITIES 2-CONTIN. PREGNANCY WITH IT’S RISKS AND ARRANGE A______ 3- T_______ PREGNANCY WITH IT’S RISKS |
ADOPTION
TERMINATE |
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PREGNANCY MAY BE REMOVED THROUGH DILATED CERVIX OR TRANSABDOMINALLY BY HYSTEROTOMY OR H_______
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HYSTERECTOMY
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D&C - DILATION OF CERVIX & SCRAPING OUT OR SUCTION OUT OR BOTH ; COMPLICATIONS INCREASE AFTER 1ST TRIMESTER; MUST BE DONE BEFORE 14-__ WKS
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15
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D&E- AFTER 16 WKS REMOVAL REQUIRES DESTRUCTION OF FETUS & SUCTIONING OF ___
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POC
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PTS WHO HAVE SURGICAL AB SHOULD RECEIVE PROPHYLACTIC ANTIBIOTICS, Rh NEG PT SHOULD GET _____
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RHOGAM
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HYGROSCOPIC DILATORS MINIMIZE TRAUMA TO CERVIX, L_______ DRAWS WATER OUT OF PROTEOGLYCANS CAUSING DISSOCIATION & ALLOWS CERVIX TO SOFTEN & DILATE
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LAMINARIA
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LOCALANESTHETIC INJECTED INTO CERVIX & IT IS DILATED TO ALLOW INTRODUCTION OF SUCTION CANNULA. P_________ IS THE MOST COMMON COMPLICATION.MOST LIKELY TO OCCUR WITH R____________ UTERUS , CAN BE SERIOUS
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PERFORATION
RETROVERTED |
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LAPAROTOMY- IN FEW CIRCUMSTANCES HYSTEROTOMY OR HYSTERECTOMY IS PREFERABLE PT WHO WANTS TERMINATION & STERILAZATION MAY BENEFIT FROM HYSTEROTOMY WITH BTL (what's BTL?)
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Tubal ligation
incision into uterus, do the abortion, then tie the tubes |
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MEDICAL INDUCTION OF ABORTION
OUTPATIENT MEDICAL ABORTION IS ACCEPTABLE ALTERNATIVE TO SURGICAL IN SELECTED WOMEN WITH PREGNANCY <__ DAYS |
49
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3 DRUGS HAVE BEEN WELL STUDIED
THE ANTIPROGESTIN- THE ANTIMETABOLITE- THE PROSTIGLANDIN- |
THE ANTIPROGESTIN- MEFEPRISTONE
THE ANTIMETABOLITE- METHOTREXATE THE PROSTIGLANDIN- MISOPROSTOL |
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THEY CAUSE ABORTION BY INCREASING UTERINE CONTRACTILITY EITHER BY REVERSING P_________ INDUCED INHIBITION OF CONTRACTIONS OR BY DIRECT UTERINE STIMULATION
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PROGESTERONE
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METHOTREXATE & MISOPROSTOL ARE TERATOGENS , so you must make sure of what?
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ABORTION IS COMPLETED
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CONSEQUENCES OF ELECTIVE ABORTION
LEGALLY INDUCED ABORTION PERFORMED BY TRAINED GYN, ESPECIALLY IN THE 1ST 2 MONTHS HAS MORTALITY RATE OF 0-7/100,000 PROCEDURES. THE RELATIVE RISK ______ FOR EACH 2 WKS BEYOND 8 WKS GESTATION a) doubles b) triples c) decreases |
DOUBLES
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ELECTIVE ABORTION - FERTILITY DOES NOT APPEAR TO BE DEMINISHED EXCEPT RARELY AS THE RESULT OF _______
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INFECTION
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OVULATION MAY RESUME AS EARLY AS 2 WKS AFTER PROCEDURE, IMPORTANT TO START PT ON what medication?
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EFFECTIVE CONTRACEPTION
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