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Medical Termination of Pregnancy (MTP)

Deliberate induction of abortion by a medical practitioner in the interest of mother?s health and life is termed as Medical Termination of Pregnancy

 

 

In India abortion of legalized by Medical Termination of Pregnancy Act of 1971 which was revised in the year 1975.


Indications

1.Therapeutic indications to save the life of the mother

 

  • Cardiac diseases-Grade III and IV
  • Chronic glomerulonephritis
  • Malignant hypertension
  • Intractable hyperemesis gravidarum
  • Cervical/Breast cancer
  • Diabetes Mellitus with retinopathy
  • Epilepsy or Psychiatric illness

 

2. Social Indications

 

  • Unplanned pregnancy
  • Pregnancy caused by rape or due to failure of contraceptive method

 

3. Eugenic: This is done under the provision of Substantial risk of the child being born with serious physical and mental abnormalities so as to be handicapped in life. The  indications (though rare) are:

 

  • Structural like Anencephaly
  • Chromosomal like Down’s Syndrome
  • Genetic like Hemophilia
  • Deformation due to teratogenic drugs(Warfarin) or radiation exposure(>10 rads) in early pregnancy
  • Rubella, a viral infection affecting in the first trimester

 

 

Methods

1. First trimester

 

 

  • Medical
  • Mifepristone
  • Mifepristone and Misoprostol
  • Methorexate and Misoprostol
  • Tamoxifen and Misoprostol

 

 

2. Surgical

 

  • Manual Vacuum Aspiration (MVA)
  • Suction evacuation and/or curettage
  • Dilatation and evacuation

 

3. Second trimester

 

  • Dilatation and Evacuation
  • Oxytocin infusion
  • Use of Prostaglandins

 

Complications

1. Immediate

 

  • Injury to cervix and uterus
  • Bleeding
  • Thrombosis/Embolism

 

2. Delayed

 

 

a) Gynecological

 

  • Menstrual Disturbances
  • Chronic Pelvic Inflammation
  • Infertility
  • Endometriosis
  • Uterine adhesions

 

b) Obstetrical

 

  • Recurrent midtrimester abortion
  • Ectopic pregnancy
  • Preterm labour
  • Dysmaturity
  • Rupture uterus
  • Rh isoimmunisation in Rh-negative women

 

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