Medical Termination

MTP SETUP
DEFINITION:
Medical termination pregnancy is a method of terminating pregnancy

using medicines. It is feasible only up to 9 weeks of pregnancy after that
surgical termination takes over. It is one of the safest modes of terminating an
unwanted pregnancy.
[OR]
Deliberate termination of pregnancy either by the medical & surgical

method before the viability of the fetus is called induction of abortion.
Indications for Medical Termination of Pregnancy:
 Failure of contraception.
 Pregnancy caused by rape.
 Possible hazard to the health of growing fetus.
 Women whos physical or mental health were endangered by the

pregnancy.
 Women facing the birth of [otentially handicapped or malformed child
 Pregnancies in unmarried girls under the age of 18 years with the consent
of gaurdian
 Pregnancies thet are results of failure in sterilization.
Preparation of equipments:
Facilities for safe and hygienic place for performing MTP in center
approved up to 12 weeks of pregnancy:
1. Gynecology examination/labor table should be available

2.Resuscitation equipments should be available (Ambu bag, Oral airway,
Oxygen cylinder with oxygen)
3. Equipments required for MVA/EVA available
4. Sterilization equipments should be available (Autoclave, Boiler, Cidex tray)
5. Essential drugs available
6. Drugs required for treatment of emergencies should be available
7. IV fluids
8. Essential supplies should be available
9. Drugs required for medical method of abortion if available (Mifepristone,

Misoprostol, Analgesics, Antiemetics)
10. Facility for transportation available if needed to transfer the pt. to higher
center
Facilities for safe and hygienic place for performing MTP in center
approved up to 20 wks of pregnancy:
1.Gynecology operation table
2. Essential equipment/instruments for performing abdominal/gynecological

surgery should be available (Ovum forceps, Foley’s catheter No.12,14, 16,
instruments for laprotomy, gynecological and abdominal surgery).
3. Anesthetic equipments should be available (Boyle’s Apparatus, endotracheal

tubes etc.)
4.Resuscitation equipments
5. Sterilization equipments
6. Drugs required for MTP

7. IV fluids
8. Back up facilities for treatment of shock should be available if needed
9. Facility for transportation available if needed to transfer the pt. to higher

center
Equipments Rationale
1.Sim’s and/ or Cusco’s speculum To Examine the vagina and cervix
2 Anterior vaginal wall retractor To retract the vaginal wall
3 Allis forceps or vulsellum (small Used to grasp the cervix. And also
toothed) used for grasp for fybroid polyp
4 Sponge holding forceps To hold the sponges
5 Blunt and sharp curette To remove the conception products
from the uterine cavity
6 Cheatle’s forceps To remove the sterilised instruments
7 Bowel for antiseptic solution
8 Proper light source/Torch for proper examine and compfortble
9 MVA aspirator and /or Electric to aspirate the remaining tissue with in
Suction machine the womb
10 Cannulae of required sizes for cannulization
11 Kidney tray to collect the waste
12 Strainer for tissues
13 Plastic bucket for chlorine solution and keeping
soiled instruments
Essential Drugs:
1. Antibiotics: Ampicilline, Amoxicilline, Cephalexin or a suitable alternative
2. Analgesic: Paracetamol, Pentazocin, Dicyclomine or a suitable alternative

3. Injection Atropine sulphate
4. Local Anaesthetic: Inj. Lignocaine 1-2%
5. Injection Diazepam
6. Uterotenics: Inj. Oxytocine, methylergometrine, Inj. Prostaglandins and/or

tablet mesoprostol
7. Dextrose 5% and Ringer lactate, IV set, Canulae or scalp vein sets
Drugs for Treatment of Emergencies:
1. Injection Adrenaline
2. Injection Aminophyline
3. Injection Sodiumbicarbonate 7.5%
4. Injection Calcium Gluconate 10%
5. Inj. Metchlopramide (suitable antiemetic).
6. Inj. Promethasine (suitable antihistamine]
7. hydrocartisone [steroid]
6 Sterile saline or water for washing before instruments that are chemically
sterilized or high level disinfected before use.
7 Chlorine solution/ bleaching powder Infrastructure required for Second

Trimester Terminations
Pre-Operative Procedure:
The patient undergoes with ultrasound and examination while receiving

oral medication before the procedure. Doctors prescribe the patient with pain
medications and antibiotics and instructions are given to follow before, during,
and after the procedure. Patient will be given with an option to choose for a
birth control method if they want to.
DURING PROCEDURE:
In this method, a set of pills named Mifepristone is given to the

patient which can be taken orally or by injection. After this initial medication,
another set of pills Misoprostol is given to the patient which can be taken
orally or inserted vaginally at home or clinic. Generally, the gap between these
two medicines is 3 to 7 days.
Along with medicines, antibiotics are also given to prevent any kind
of infection. This medication is preceded and followed by a medical
examination to determine positive pregnancy and positive abortion.
AFTER PROCEDURE:
Medical terminating pregnancy is a painful procedure both physically

and mentally that continues for a couple of weeks. It is always suggested to
take complete rest for complete recovery before getting on with your daily life.
It is preferable to have a support system to cheer up your emotional mood
swings and drastic hormones change that you go through after abortion.
In the case of cramps, it is preferred to massage and use heating pads to

relieve cramps. patient can also use medicine like ibuprofen to reduce cramps
and pain. Staying hydrated if are feeling vomiting or diarrhea. Patient should
use a tight-fitting bra to avoid breast tenderness.
Clean and replace the articles which are used diring medical termination of
pregnancy.
Remove gloves and wash the hands

Record the details of termination of pregnancy and condition of the mother in
the patient chart.

Medical Termination

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What are the indications for medical termination of pregnancy?

What are the indications for medical termination of pregnancy?

What are the steps involved in medical termination of pregnancy using medicines?

What are the steps involved in medical termination of pregnancy using medicines?

MTP SETUP

Medical termination pregnancy is a method of terminating pregnancy

Deliberate termination of pregnancy either by the medical & surgical

Indications for Medical Termination of Pregnancy:

 Pregnancy caused by rape.

 Possible hazard to the health of growing fetus.

 Women whos physical or mental health were endangered by the

 Women facing the birth of [otentially handicapped or malformed child

 Pregnancies thet are results of failure in sterilization.

1. Gynecology examination/labor table should be available

3. Equipments required for MVA/EVA available

4. Sterilization equipments should be available (Autoclave, Boiler, Cidex tray)

5. Essential drugs available

6. Drugs required for treatment of emergencies should be available

8. Essential supplies should be available

9. Drugs required for medical method of abortion if available (Mifepristone,

1.Gynecology operation table

2. Essential equipment/instruments for performing abdominal/gynecological

3. Anesthetic equipments should be available (Boyle’s Apparatus, endotracheal

6. Drugs required for MTP

8. Back up facilities for treatment of shock should be available if needed

9. Facility for transportation available if needed to transfer the pt. to higher

1. Antibiotics: Ampicilline, Amoxicilline, Cephalexin or a suitable alternative

2. Analgesic: Paracetamol, Pentazocin, Dicyclomine or a suitable alternative

4. Local Anaesthetic: Inj. Lignocaine 1-2%

6. Uterotenics: Inj. Oxytocine, methylergometrine, Inj. Prostaglandins and/or

7. Dextrose 5% and Ringer lactate, IV set, Canulae or scalp vein sets

Drugs for Treatment of Emergencies:

3. Injection Sodiumbicarbonate 7.5%

4. Injection Calcium Gluconate 10%

5. Inj. Metchlopramide (suitable antiemetic).

6. Inj. Promethasine (suitable antihistamine]

7 Chlorine solution/ bleaching powder Infrastructure required for Second

The patient undergoes with ultrasound and examination while receiving

In this method, a set of pills named Mifepristone is given to the

Medical terminating pregnancy is a painful procedure both physically

In the case of cramps, it is preferred to massage and use heating pads to

Remove gloves and wash the hands

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