induced abortion n named pregnancy termination n two
induced abortion
n -named pregnancy termination. n -two doctor at least should decide induced abortion when these are greater risk physically & mentally on mother & child , also there is risk of abnormality. n -termination prior to 24 weeks or before 20 weeks gestation. n -counseling includes social , medical , & psychological aspect
Methods of termination of pregnancy n -screening for STIs & give antibiotic. n -anti-D for RH –ve , after termination. n -after termination check physical &contraceptive measures. n -12 % who need termination if does not given antibiotic can develop PID & c. trachomatis
Surgical termination of pregnancy n Most common used in the 1 st trimester n -use of dilator to open the cervix this called suction curette n -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 : n -used after 14 weeks gestation instead of E&C n -progesterone antagonist { mifepristone} given orally then 36 -48 hours orally or vaginal pessary , success rate more than 35 %. n -in the second trimester : vaginal prostaglandin every 3 hours n
n -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 : n ** early complication: n Bleeding –uterine perforation –damage pelvic viscera –cervical laceration – retained product & sepsis-small failure rate n **late complications: n -infertility –cervical incompetence – isoimmunization –psychiatric disease
n NB; unsafe abortion one cause of maternal death which lead to septic abortion ( commonly illegal & used in non sterile technique psychological sequelae of termination : n ? -fatal abnormality n -? pregnancy wanted or not
n -? previous diagnosis of the problem n -feeling of distress & traumatic experience n -need support from Dr, midwife husband –family support.
** role of midwife n -primary caring of mother n -provide well care to mother n -prevent harm n -assist in blood test , & amniocentesis n -give advice & necessary information. n -ready to care with her in case of emergency.
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