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Claudine Domoney
www.rcog.org.uk
TOP in Britain
186 000 in England 99.8% in NHS
& Wales
11500 in Scotland
annually
have in lifetime
hospitals in Scotland
Induced abortion
Surgical TOP
Medical TOP
7 weeks 24 weeks
Any gestation
Hysterotomy > 24
weeks
Pre 63 days
amenorrhoea
Post 63 days
Certificate A legal
requirement
Cervical trauma
1/1000
Uterine perforation
Failed abortion
2/1000
Infection
Up to 10%
with screening
and prophylaxis
1-4/1000
Anaesthetic
NB use of cervical priming agents
Pregnancy Termination Read More
Psychological
Mifepristone and
Misoprostol alone
Mifepristone and
misoprostol
gemeprost
Methotrexate
Methotrexate and
misoprostol
NB limited availability of
antiprogesterone
Contraindications
Known allergy to misoprostol or
Cautions
Patients with prosthetic heart valves or who have
Fraser guidelines
Gillick competence
lawful for doctors to provide contraceptive advice and
treatment without parental consent providing certain
criteria are met
Other considerations
Follow up
Pregnancy test >3/52
Anti D
Contraception
Antibiotics
Analgesia
Counselling
Pregnancy Termination Read More
Case 1
Age 23
With partner
No contraception
Ambivalent
12 weeks pregnant
Case 2
Age 44
Teenage children
5 weeks pregnant
BMI 35
Case 3
Age 14
With older boyfriend
8 weeks pregnant