2. INDUCTION OF ABORTION -: Deliberate
termination of pregnancy either by medical
or by surgical method before the viability
of the fetus is called induction of
abortion.
3. ● The induced abortion may be legal or
illegal (criminal) .
● There are many countries in the globe
where the abortion is not yet legalized .
● In India , the abortion was legalized by
“medical termination of pregnancy act”
1971, and has been enforced in the
year April 1972
● The provision of the act have been revised
in 1975.
4. ● Medical termination of pregnancy (MTP)-
: since legalization of abortion in India ,
deliberate induction of abortion by a
registered medical practitioner in the
interest of mother ’s health and life is
protected under the MTP act .
● The following provisions are laid down
under the MTP ACT 1971.
5. ● The continuation of pregnancy would
involve serious risk of life or grave injury to
the physical and mental health of the
pregnant woman
● There is a substantial risk of the child being
born with serious physical and mental
abnormalities so as to be handicapped in
life
● Pregnency caused by the failure of a
contraceptive
6. ● When the pregnancy is cause by rape,both
in case of major and minor girl and in
mentally imbalanced women .
INDICATION OF TERMINATION UNDER
MTP ACT 1971-:
● To save the life of mother
● In case of cardiac disease
● Any history of neoplasm
● Dibetes mellitus
● Psychiatry illness
7. ● Cervical or breast malignancy
● Malignant hypertension
● Chronic glomerulonephritis
● Intractable hyperemesis gravidarum
Social indication-:
● Pregnency caused by rape
● Contraceptive failure
● Unplanned pregnancy with low
socioeconomic status
8. ● Injury to the physical or mental health of the
pregnant woman
● Down syndrome
● Any other indication to prevent grave.
● Teratogenic effect of drugs
● Radiation
Note-: A viral infections affecting in the first
trimester ( infections with rubella ) , is an
indication of termination .
9.
10. Surgical -:
● Menstrual regulation-: it is the
aspiration of the endometrial cavity
within 14 days of missed period in a
women with previous normal cycle .
● The operation is done as an out
patient or an office procedures , and
done with aseptic technique .
11.
12. ● Vaccume aspiration (MVA/EVA)-: this
procedure is similar to menstrual regulation
and is done as outpatient basis .
● This procedure may be manual vaccum
aspiration (MVA) or electric vaccume
aspiration (EVA) and is highly effective
(98to100%)
13. ● Suction evacuation or curettage
● Diltation and evacuation
(1) Rapid method
(2)slow method
14. (2) Second trimester (13 to 20 weeks)
● Prostaglandins PGE1(misoprostol),15methyl
PGF2alpha
(Carboplast), PGE2 (dinoprostone) and their
analogs (use intravaginal, intramuscular, or
intra amniotically)
● Diltation and evacuation ( at 13- 14 weeks )
15. ● Oxytocin infusion -: high dose
oxytocin used along with either of the
above two methods .
● Hysterotomy -: abdominal
hysterotomy less commonly done
16. RECOMMENDATIONS-: In the revised rule , a
ragisterd practitioner is qualified to perform an
MTP if he fullfil following criteria
● Assisted in at least 25 MTP in an
authorized centre and having a certificate
● Having a diploma or degree in obstetrics
and gynecology
● Has got 6 month house surgeon training in
obstetrics and gynecology
17. ● Termination can only performed in hospital,
established by private or government
sector.
● Pregnancy can only be terminated on the
written consent of the women.
● Pregnancy in minor girl ( age below 18
year) or lunatic can not be terminated
without written consent of the parent or
legal guardian .
18. ● Termination is permitted up to 20 week
of pregnancy .when pregnancy is
exceeded 12 weeks , opinions of two
medical practitioner is required.
● The abortion has to be performed
confidentially and to be reported to the
director of health services of the state
in prescibed form .
19. COMPLICATION OF MEDICAL
TERMINATION OF PREGNANCY -:
● Trauma to the cervix and the uterus
● Hameorrhage and shock due to trauma
● Sepsis (pain , bleeding, fever )
● Menstrual irregularities
● Chronic pelvic inflammatory disease
● Scar , endometriosis
