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Questions and Answers
What is the normal procedure following a surgical termination of pregnancy regarding home recovery?
What is the normal procedure following a surgical termination of pregnancy regarding home recovery?
- Women must stay in the hospital for observation for three days.
- Women can typically return home on the same day after the procedure. (correct)
- Women are encouraged to stay in bed for two weeks post-procedure.
- Women must have a follow-up appointment before they are discharged.
Which of the following is considered excessive bleeding following a termination of pregnancy?
Which of the following is considered excessive bleeding following a termination of pregnancy?
- Spotting of blood for only one day.
- Pad saturated with 50mls of blood.
- Inco sheet saturated with 500mls of blood. (correct)
- Pad saturated with 30mls of blood.
What is a necessary action if excessive bleeding occurs post-termination?
What is a necessary action if excessive bleeding occurs post-termination?
- Prepare the woman for immediate surgery.
- Encourage the woman to rest and monitor symptoms at home.
- Provide intravenous fluids and wait for observation.
- Call 999 and pre-alert the nearest obstetric unit. (correct)
Which symptom is NOT associated with a prolapsed uterus?
Which symptom is NOT associated with a prolapsed uterus?
What classification of urgency applies if there are time-critical features present during the management of gynaecological conditions?
What classification of urgency applies if there are time-critical features present during the management of gynaecological conditions?
Which statement accurately reflects the post-operative care awareness for women post-termination?
Which statement accurately reflects the post-operative care awareness for women post-termination?
Which of the following describes the possible symptoms of a prolapsed uterus?
Which of the following describes the possible symptoms of a prolapsed uterus?
What should be administered if a woman presents with shock and is diagnosed with a gynaecological condition?
What should be administered if a woman presents with shock and is diagnosed with a gynaecological condition?
What is the legal time frame for a termination of pregnancy for social reasons in the UK?
What is the legal time frame for a termination of pregnancy for social reasons in the UK?
What medications are typically used in a medical termination of pregnancy (MTOP)?
What medications are typically used in a medical termination of pregnancy (MTOP)?
Which of the following is a rare safeguarding consideration related to termination of pregnancy?
Which of the following is a rare safeguarding consideration related to termination of pregnancy?
In which circumstance can a termination of pregnancy occur after 24 weeks legally?
In which circumstance can a termination of pregnancy occur after 24 weeks legally?
What role does an ultrasound scan typically play in a medical termination of pregnancy?
What role does an ultrasound scan typically play in a medical termination of pregnancy?
What is a legal requirement in the UK if female genital mutilation (FGM) is disclosed or suspected in someone under 18?
What is a legal requirement in the UK if female genital mutilation (FGM) is disclosed or suspected in someone under 18?
What procedure is considered to be a medical termination of pregnancy (MTOP)?
What procedure is considered to be a medical termination of pregnancy (MTOP)?
Which of the following is a potential complication following surgical termination of pregnancy?
Which of the following is a potential complication following surgical termination of pregnancy?
What is the primary intent of the procedures involved in female genital mutilation (FGM)?
What is the primary intent of the procedures involved in female genital mutilation (FGM)?
Which statement about vaginal tissue damage is inaccurate?
Which statement about vaginal tissue damage is inaccurate?
In which condition could Type 3 or Type 4 FGM present a significant complication during childbirth?
In which condition could Type 3 or Type 4 FGM present a significant complication during childbirth?
What is the primary aim of safeguarding referrals when genital trauma is suspected?
What is the primary aim of safeguarding referrals when genital trauma is suspected?
What might cause vaginal bleeding post-surgical termination of pregnancy?
What might cause vaginal bleeding post-surgical termination of pregnancy?
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Study Notes
Safeguarding and Emergency Response
- Low threshold for referring cases of conveyance and safeguarding; police may need to be involved.
- Compassion is essential when addressing sensitive situations.
Surgical Termination of Pregnancy
- Procedure to remove pregnancy, performed under local, sedation, or general anaesthetic based on gestation.
- Often an outpatient surgery; patients typically return home the same day.
Post-Termination Care
- Normal to experience bleeding and discomfort for up to 2 weeks; call 999 if excessive bleeding occurs.
- Excessive bleeding is defined as postpartum haemorrhage, requiring a pre-alert to the nearest obstetric unit.
Prolapsed Uterus
- Condition where the uterus descends into the vagina due to weakened pelvic floor structures.
- Typically not life-threatening but can lead to shock or vaso-vagal symptoms.
Symptoms of Prolapsed Uterus
- Heaviness in the lower abdomen or genital area.
- Discomfort or numbness during intercourse.
- Feeling or seeing a bulge or lump in the vagina.
- Urinary issues may arise.
Management of Gynaecological Conditions
- ABCDE approach for assessment; alert for time-critical features.
- Consider paramedic assistance; administer oxygen if patient is shocked or hypovolaemic.
- For non-time-critical cases, conduct secondary survey and transfer to emergency department.
- Provide empathy, support, and pain relief as needed.
Termination of Pregnancy Overview
- Abortion rate was 18.6 per 1,000 women in the UK in 2021; can occur for social or medical reasons.
- Legal up to 24 weeks; after 24 weeks permitted under limited circumstances (e.g., risk to woman’s life).
Medical Termination of Pregnancy (MTOP)
- MTOP utilizes ultrasound to confirm gestational age; women can access medication via telemedicine due to COVID-19.
- Involves two medications, Mifepristone and Misoprostol, taken 24-48 hours apart.
Safeguarding Considerations in Termination
- Risks of unsafe terminations increase with early access to MTOP above 10 weeks.
- Use Newborn Assessment Card for decision-making concerning viability and resuscitation.
Vaginal Bleeding Causes
- Most vaginal bleeding is not life-threatening but may cause alarm; causes include menstruation, post-termination, gynecological procedures, cancers, and trauma.
Genital Trauma
- Encompasses damage to external (labia, vaginal opening) and internal genital areas (hymen, cervix).
- Includes post-coital tears, female genital mutilation (FGM), penetrating trauma, and sexual abuse; safeguarding referrals required for any suspicion.
Female Genital Mutilation (FGM)
- Procedures involving partial or total removal of external female genitalia; recognized as a form of child abuse and illegal in the UK.
- Typically performed on girls between infancy and age 15, primarily before puberty.
Reporting Suspected FGM
- Safeguarding referral required if FGM is disclosed or physical signs are evident in minors.
- Mandatory reporting to police under the Serious Crime Act 2015 for observed cases, especially Type 3 or Type 4 FGM during labor.
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