Pregnancy Options and Abortion

What is Medical First Trimester Abortion

Occurring from 5-10 weeks if medical but can be done later if surgical

1. Done via two medications that are used together

   1. Mifepristone - an anti-progesterone that binds to progesterone receptors killing off progesterone in supporting early pregnancy

      1. causes decidual necrosis and cervical softening

      2. increases contractility

      3. taken prior to misoprostol to prime for response

   2. Misoprostol

      1. Prostaglandin E1 analog that triggers uterine contractions to expulse the pregnancy

What are the contraindications with medication abortion?

Contraindications for medical abortion is an ectopic pregnancy, drugs require that the fetus is actually in the uterus
→ is acceptable in multiple gestation
→ risk of anemia

What is Surgical Abortion

First Trimester involves Dilate the cervix and then vacuum out products of conception

• at gestational ages greater than 12 weeks can use misoprostol for cervical dilation

Second Trimester

• Premedicate with mifepristone, dilate the cervix, and then anesthetize them and take out the fetus

What is Induction

Induction is done in patients that are for abortions done later and give the option to hold the fetus

1. Misoprostol is used