Induced Abortion

DEFINITION

The termination of a pregnancy medically or operatively before fetal viability; definition of viability varies from state to state

ASSESSMENT OF THE PATIENT

Abortion may not be denied in first 3 months of pregnancy in any state.

Physical assessment is crucial before an elective abortion:

■ Ultrasound should be performed if there is a discrepancy between dates and uterine size.

■ Patient's blood type and Rh type must be evaluated; if Rh negative, RhoGAM should be administered prophylactically.

■ Careful patient counseling should be performed.

TYPES OF INDUCED ABORTION

Elective voluntary: Interruption of pregnancy at the request of the mother Therapeutic: Interruption of pregnancy for the purpose of safeguarding the health of the mother

INDICATIONS FOR THERAPEUTIC ABORTION

Maternal Indications

■ Cardiovascular disease

■ Metabolic (e.g., proliferative diabetic retinopathy)

■ Neoplastic (e.g., cervical cancer; mother needs prompt chemotherapy)

■ Neurologic (e.g., Berry aneurysm; cerebrovascular malformation)

■ Renal disease

■ Intrauterine infection

■ Severe preeclampsia/eclampsia

Fetal Indications

■ Major malformation (e.g., anencephaly)

METHODS OF ABORTION

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