What people need to know about abortions? An abortion is a termination of a pregnancy at a certain amount of weeks. People will learn what an abortions. There is two different kinds of abortions. Everyone will know what the complications are that come with a TOP. The side effects and if there is any long term complications after the procedure is done. In this paper everyone will learn everything that they need to know about abortions by the time they read the whole paper.
The two methods of termination is either surgical or medical TOP. A medical TOP involves oral mifepristone, a progestin antagonist which sensitises the myometrium to prostaglandin induced contractions and ripens the cervix, followed by misoprostol, a synthetic prostaglandin analogue, orally and or vaginally, which causes uterine contractions and cervical dilatation. The addition of the progesterone antagonist reduces the induction to abortion interval, analgesia required and prostaglandin dose(Farquhar et al. 2009 pg.1). A surgical termination consists of prior dilapan rod insertion and misoprostol priming to dilate and soften the cervix, followed by D&E under local or general anesthetic. Dilapan rods are hydrophilic polymer rods which work by absorbing fluid and slowly expanding, therefore causing cervical dilatation(Farquhar et al. 2009 pg1).The protocol used for medical TOP was as follows: 600 mg mifepristone orally, admission to gynecology ward 36-48 hours later, 800 micrograms misoprostol vaginally then 400 micrograms misoprostol orally at three hourly intervals, with a maximum of four oral doses. If significant bleeding occurred prior to planned admission, admission occurred at that time and the misoprostol regimen commenced. Manual removal of the placenta was recommended after delivery if the placenta did not deliver spontaneously. Pain relief was offered at regular intervals during the procedure according to a protocol that included morphine or pethidine given intravenously, in women with more severe pain a patient controlled anesthesia pump was made available that administered morphine(Farquhar et al. 2009 pg 2). The protocol for surgical termination was as follows: 2 dilapan rods was inserted 12 to hours prior to the procedure to widen the cervix, misoprostol 400 micrograms orally or vaginally one to three hours before the procedure, followed by D&E. During the procedure intravenous fentanyl (maximum dose of 20 mg) and midazolam (maximum dose 3 mg) was given and rectal suppositories of paracetamol(1 gm) and voltaren (75 mg) were given(Farquhar et al. 2009 pg. 2).
The most common method of contraception among contraceptives failures leading to TOP was condom failure when condoms were used alone (66%). The combined oral contraceptive pill or( COCP) was 14%. The Emergency contraceptive pill (ECP) was 4%. The progesterone only pill was 3%. The Depo Provera was 2%. When Condoms was used with the COCP was 1%. Condoms in use with the ECP was 4% and anything unknown was about 3%. That is what was said in the article written by Mauelshagen et al. 2011.
There was a significant difference in gestational age between the two methods, with 81% of surgical TOP performed between 13 and 16 weeks and 74 % of medical TOP were performed between 17 and 20 weeks(Mauelshagen et al. 2009 pg.2).Surgical TOP was more common among younger women, having Top at earlier gestations, and most commonly for maternal mental or physical health reasons.(Farquhar et al. 2009, pg. 2). Studies on early medical abortion up to 63 days LMP show that women experience more pain and bleeding with increasing the gestational age, but do not have a higher complication rate overall.(Bracken et al. 2011, pg 5.).Surgical termination is most often performed at an earlier gestation, with ninety-nine percent performed before the end of the 17th week.(Farquhar et al. 2009, pg.3). While medical Top is performed at or beyond the 16th week.(Farquhar et al. 2009, pg 3). Ideally TOP should be...
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