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Family Medicine - Abortion Options and Aneuploidy Screen
adsf
31
Other
Graduate
06/25/2011

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Cards

Term
What is the difference between EC and medical abortion
Definition
1) prevents a pregnancy after unprotected sex
2) ends a pregnancy
Term
What is the components of the abortion pill
Definition
- mifepristone AND misoprostol
Term
How does EC vs abortion pill work?
Definition
1) contain progestin which delays ovulation
2) mifepristone stops growth; misoprostol causes cramping
Term
When is EC available? Abortion pill?
Definition
1) sooner, the better, up to 5days post unprotected sex
2) up to 9 weeks after the last period
Term
How well does the EC vs abortion pill work?
Definition
1) 59-90% decreased risk of getting pregnant
2) 98-99% termination rate; must have aspiration abortion if unsuccessful
Term
How late can the abortion pill vs aspiration abortion be used?
Definition
1) up to 9 weeks from LMP
2) up to 12 weeks from LMP
Term
What is the termination rate for aspiration abortion
Definition
- 99%
- if it fails, must repat aspiration abortion
Term
What is an open adoption? closed adoption?
Definition
1) birth parent and adopting family have some contact. birth mother selects adopting family
2) birth mother and adopting family do not have any information about one another (less common)
Term
What are the adoption arrangement options?
Definition
1) agency adoptions
2) independent adoptions (adoption attorneys)
3) adoption by a relative
Term
What rights do the fathers have in adoption plans
Definition
- differ by state
- most states the fathermust be informed fo the plan to place for adoption
- some states the father's consent is required
Term
What percent of pregnancies end in abortion? What percent are unplanned pregnancies?
Definition
1) 22%
2) 50%
Term
What percent of all abortions are obtained by:

15-17yrso
18-19yrso
20-24yrso
25-29yrso
Definition
1) 6%
2) 11%
3) 33%
4) 24%

Total: 74% of all abortions are obtained by pts under the age of 30yrso
Term
What percent of abortions are obtained by women who have one or more children?
Definition
1) 68%
Term
What percent of women who have abortions had used a contraceptive the month they became pregnant?
Definition
1) 54%; 76% on pill and 49% on condom were using inconsistently
Term
What percent of women who have abortions have never used a method of birth control? What populations is nonuse greatest?
Definition
1) 8%
2) young, poor, black, hispanic, and/or less educated
Term
What was the finding in Roe v Wade
Definition
- women, in consulation with their physician, have a constitutionally protected right to have an abortion in the early stages of pregnancy (before viability) free from government interference
Term
What was the ruling in Planned Parenthood v Casey
Definition
1) weakened legal protections previously afforeded women and physicians by giving states the right to enact restrictions that do not create an "undue burden" for women seeking abortion
Term
How many states enforce parental conset or notification laws for minors seeking an abortion?
Definition
- 35 states
- minors may seek a court order authorizing the procedure
Term
How frequent are chromosomal abnormalities in live births?
Definition
- 1/160
Term
What isthe major cause of autosomal trisomies?
Definition
- result of nondisjunction during maternal meiosis
Term
Why is maternal age a poor screening criterion for chromosomal abnormalities?
Definition
- the majority of children with Down's syndrome are born to women younger than 35yrso
Term
What is the major limitation to screening tests for chromosomal abnormalities?
Definition
- false positive and false negative results
Term
What is trisomy 21 effect on maternal levels of

hCG
estriol (unconj)
inhibin A
aFP
Definition
1) high
2) low
3) high
4) low
Term
What is the most common screening test performed between 15 and 22 weeks' gestation for chromosomal abnl
Definition
- quadruple screening
Term
What is the first trimester screening for chromosomal abnormalities?
Definition
- pregnancy-associated plasma protein A test and hCG WITH measurement of nuchal translucency
Term
What is the stepwise screening strategy for chromosomal abnormalities?
Definition
1) if the risk of aneuploidy is greater than a predetermined cutoff point, the patient is offered the option of a dx test
2) if she does not proceed, she will receive the quadruple screening and obtain a revised and final risk assessment based on the first and second trimester measurements
Term
What is the contingent sequential screening strategy for chromosomal abnormality testing
Definition
- stratifies women according to the initial adjusted risk of Down's syndrome
- only women win intermediate risk undergo the second-trimester screening
Term
What is the rate of pregnancy loss after U/S guided amniocentesis?
Definition
1) less than 1/200 reported in the 1970s but no recend randomized studies have assessed the risk.
- observational studies have shown fetal loss of .22%
Term
Why is amniocentesis before 15wks discouraged?
Definition
- high rates of fetal loss
- leakage of amniotic fluid
- fetal talipes equinovarus
Term
What information should women presenting for prenatal care be routinely given?
Definition
1) age-related risk of fetal aneuploidy
- implications of a dx of aneuploidy
- available screening tests
- informed that screening tests do not detect all cases
- information re: dx tests
Term
What pregnancy dates is CVS appropriate for? amniocentesis?
Definition
1) 10-12wks
2) 15-20wks
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