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induced abortion. -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 . -termination prior to 24 weeks or before 20 weeks gestation .
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-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 . • -termination prior to 24 weeks or before 20 weeks gestation . • -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 36-48 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.