induced abortion

-named pregnancy termination. -named pregnancy termination. -two doctor at least should decide induced abortion when these are greater risk physically & mentally on mother & child, also there is risk of abnormality. -two doctor at least should decide induced abortion when these are greater risk physically & mentally on mother & child, also there is risk of abnormality. -termination prior to 24 weeks or before 20 weeks gestation. -termination prior to 24 weeks or before 20 weeks gestation. -counseling includes social,medical, & psychological aspect -counseling includes social,medical, & psychological 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 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.