Termination of Pregnancy
MSc in Cardiology 2010-2011-CVSM 5001 Basic Cardiology (28 Dec 2010)
Objectives of this Lecture
Termination of Pregnancy: Ethical and Practical Consideration
Tam, Wing Hung Associate Professor Department of Obstetrics & Gynaecology CUHK
1. Importance of pre‐conceptional counselling for patients with cardiac disease 2. Conditions for TOP 3. Legal aspect of TOP 4. Methods of TOP 5. Risk of TOP: specific to cardiac patient 6. An example of cardiomyopathy
Physiological Changes
• Increase in the intravascular volume • Increase in cardiac output • Lowering in the systemic BP • • • • •
In case of Pregnancy Complications:
Antepartum hemorrhage Preterm labour Pre‐eclampsia Blood loss at delivery Postpartum hemorrhage
Cardiac Conditions
• High risk of maternal mortality:
Eisenmenger’s syndrome Severe pulmonary hypertension Cardiomyopathy Marfan syndrome (aortic root dilatation > 4 cm)
Pre‐conceptional Counselling
• All women with significant cardiac disease at reproductive age • Assess the risk of undergoing pregnancy • Discuss on the suitable choice of contraception
MSc in Cardiology 2010-2011-CVSM 5001 Basic Cardiology (28 Dec 2010)
Termination of Pregnancy
• Abortion • Induced abortion • Ends the life of an unborn fetus • Ethical, legal & medical issues involved
Considerations
• Balance between the life of the unborn fetus and the risk of the mother if she goes through pregnancy and delivery
Legal Aspect
• Carried out in a hospital or clinic maintained by the Government or in an approved hospital or clinic, unless to save the life of the pregnant woman; or to prevent grave permanent injury to the physical or mental health of the pregnant woman
• 2 registered medical practitioners are of the opinion, formed in good faith, that TOP is necessary because ….
If Continuation of Pregnancy …
• would involve risk to the life of the pregnant woman > if the pregnancy were terminated • would involve risk of injury to the
Objectives of this Lecture
Termination of Pregnancy: Ethical and Practical Consideration
Tam, Wing Hung Associate Professor Department of Obstetrics & Gynaecology CUHK
1. Importance of pre‐conceptional counselling for patients with cardiac disease 2. Conditions for TOP 3. Legal aspect of TOP 4. Methods of TOP 5. Risk of TOP: specific to cardiac patient 6. An example of cardiomyopathy
Physiological Changes
• Increase in the intravascular volume • Increase in cardiac output • Lowering in the systemic BP • • • • •
In case of Pregnancy Complications:
Antepartum hemorrhage Preterm labour Pre‐eclampsia Blood loss at delivery Postpartum hemorrhage
Cardiac Conditions
• High risk of maternal mortality:
Eisenmenger’s syndrome Severe pulmonary hypertension Cardiomyopathy Marfan syndrome (aortic root dilatation > 4 cm)
Pre‐conceptional Counselling
• All women with significant cardiac disease at reproductive age • Assess the risk of undergoing pregnancy • Discuss on the suitable choice of contraception
MSc in Cardiology 2010-2011-CVSM 5001 Basic Cardiology (28 Dec 2010)
Termination of Pregnancy
• Abortion • Induced abortion • Ends the life of an unborn fetus • Ethical, legal & medical issues involved
Considerations
• Balance between the life of the unborn fetus and the risk of the mother if she goes through pregnancy and delivery
Legal Aspect
• Carried out in a hospital or clinic maintained by the Government or in an approved hospital or clinic, unless to save the life of the pregnant woman; or to prevent grave permanent injury to the physical or mental health of the pregnant woman
• 2 registered medical practitioners are of the opinion, formed in good faith, that TOP is necessary because ….
If Continuation of Pregnancy …
• would involve risk to the life of the pregnant woman > if the pregnancy were terminated • would involve risk of injury to the