Downloaded 144 times
Uploaded bySalini Mandal
MEDICAL TERMINATION OF PREGNANCY
Medical termination of pregnancy can be performed for medical reasons to save the life of the mother, for social reasons such as an unplanned pregnancy in a woman with low socioeconomic status, or for eugenic reasons if abnormalities are found in the fetus. Termination is allowed up to 20 weeks and requires consent from the woman and in some cases her guardian. In the first trimester, termination can be performed through medical methods using mifepristone and misoprostol or through surgical vacuum aspiration. In the mid-trimester, prostaglandins or dilatation and evacuation are used. Complications can include cervical injuries, hemorrhage, infections, and future risks to pregnancy like preterm labor or ect
More Related Content
Similar to MEDICAL TERMINATION OF PREGNANCY
More from Salini Mandal
MEDICAL TERMINATION OF PREGNANCY
- 1.
- 2. • The continuationof pregnancy would involve serious risk of life or grave injury to the physical and mental health of the pregnant woman. • There is a substantial risk of the child being born with serious physical and mental abnormalities so as to be handicapped in life. • When the pregnancy is caused by rape, both in cases of major and minor girl and in mentally imbalanced women. • Pregnancy caused as a result of failure of a contraceptive.
- 3. INDICATIONS FOR TERMINATIONUNDER THE MTP ACT
- 4. TO SAVE THELIFE OF THE MOTHER • (i) Cardiac diseases with history of decompensation in the previous pregnancy or in between the pregnancies • (ii) Chronic glomerulonephritis • (iii) Malignant hypertension • (iv) Intractable hyperemesis gravidarum • (v) Cervical or breast malignancy • (vi) Diabetes mellitus with retinopathy • (vii) Epilepsy or psychiatric illness with the advice of a psychiatrist.
- 5. SOCIAL INDICATIONS • Toprevent grave injury to the physical and mental health of the pregnant woman • unplanned pregnancy with low socioeconomic status • caused by rape or unwanted pregnancy caused due to failure of any contraceptive device
- 6. EUGENIC • Structural (Anencephaly),chromosomal (Down’s syndrome) or genetic (Hemophilia) abnormalities of the fetus. • When the fetus is likely to be deformed due to action of teratogenic drugs in early pregnancy. • Rubella, a viral infection affecting in the first trimester, is an indication for termination
- 7.
- 8. •RMP • assistedin at least 25 MTP in an authorized center and having a certificate. • One has got six months house surgeon training in obstetrics and gynecology. • One has got diploma or degree in obstetrics and gynecology.
- 9. • Termination canonly be performed in hospitals, established or maintained by the government or places approved by the government. • Pregnancy can only be terminated on the written consent of the woman. Husband‘s consent is not required. • Pregnancy in a minor girl (below the age of 18 years) or lunatic cannot be terminated without written consent of the parents or legal guardian.
- 10. • Termination ispermitted upto 20 weeks of pregnancy. When the pregnancy exceeds 12 weeks, opinion of two medical practitioners is required. • The abortion has to be performed confidentially and to be reported to the Director of Health Services of the State in the prescribed form.
- 11. FIRST TRIMESTER TERMINATION OFPREGNANCY
- 12. MEDICAL METHODS OFFIRST TRIMESTER ABORTION • Mifepristone (RU-486) and Misoprostol
- 13. SURGICAL METHODS OFFIRST TRIMESTER ABORTION • VACUUM ASPIRATION (MVA/EVA) is done upto 12 weeks with minimal cervical dilatation • SUCTION EVACUATION AND/OR CURETTAGE • DILATATION AND EVACUATION
- 14. DILATATION AND EVACUATION •Rapid method: This can be done as an outdoor procedure with diazepam sedation and paracervical block anesthesia • Slow Method: Slow dilatation of the cervix is achieved by inserting laminaria tents into the cervical canal This is followed by evacuation of the uterus after 12 hours
- 15. MID TRIMESTER TERMINATION OFPREGNANCY
- 16. MEDICAL METHODS • PROSTAGLANDINS They act on the cervix and the uterus • OXYTOCIN: used with intravenous normal saline along with any of the medications
- 17. SURGICAL METHODS • Between13 and 15 weeks: Dilatation and Evacuation • Between 16 and 20 weeks: INTRAUTERINE INSTILLATION OF HYPERTONIC SOLUTION • There is liberation of prostaglandins following necrosis of the amniotic epithelium and the decidua. This in turn excites uterine contraction and results in the expulsion of the fetus.
- 18.
- 19. IMMEDIATE (1) Injury tothe cervix (cervical lacerations) (2) Uterine perforation during D and E (3) Hemorrhage and shock due to trauma, incomplete abortion, atonic uterus or rarely coagulation failure (4) Thrombosis or embolism (5) Postabortal triad of pain, bleeding and low grade fever due to retained clots or products.
- 20. REMOTE • Gynecological complications (a)menstrual disturbances (b) chronic pelvic inflammation (c) infertility due to cornual block (d) scar endometriosis (1%) and (e) uterine synechiae leading to secondary amenorrhea.
- 21. • Obstetrical complications (a)recurrent midtrimester abortion due to cervical incompetence, (b) ectopic pregnancy (three-fold increase), (c) preterm labor, (d) dysmaturity, (e) increased perinatal loss, (f) rupture uterus, (h) failed abortion and continued pregnancy.
- 22. MORTALITY • First trimester:The maternal death is lowest • Midtrimester: The mortality rate increases 5–6 times to that of first trimester