PRACTICE

1. All of the following drugs have been used for medical abortion
except:
A. Mifepristone
B. Methotrexate
C. Misoprostol
D. Atosiban
• (AIIMS, 2021)
• 2. Blighted ovum is characterised by:
A. Synaptic knobs
B. Avascular villi
C. Intervillous hemorrhage
D. None
(FMGE, 2021)
3
• For medical termination of pregnancy (MTP), the consent is to be
obtained from:
• A. Only husband
• B. Only wife
• C. Both husband and wife
• D. Neither
(INICET,2021)
Ans.B.Only wife
As per MTP Act, MTP can be done if:
1. The continuance of the pregnancy would involve a risk to the life of the pregnant woman or risk
of grave injury to her physical or mental health.
2. If the pregnancy is caused by rape.
3. There exists substantial risk that if the child were born, it would suffer from some physical or
mental abnormalities so as to be seriously handicapped.
4. Pregnancy caused as a result of failure of a contraceptive.
Section 3(4) of MTPA clarifies as to whose consent would be necessary for termination of
pregnancy. No pregnancy shall be terminated except with the consent of the pregnant woman. It
is important to note, in this section, that only the consent of the woman is the essential factor for
termination of her pregnancy. The husband’s consent is irrelevant. Therefore, if the woman wants
an abortion but her husband’s objects to it, the abortion can still be done. However, if the woman
does not want an abortion but her husband wants, it cannot be done.
However, the consent of the guardians is needed in the case of minors or lunatics.
4
• A 24-year-old woman has had three first-trimester spontaneous
abortions. Which of the following statements concerning
chromosomal aberrations in abortions is true?
• a. 45,X is more prevalent in chromosomally abnormal term babies
than in abortus products.
• b. Approximately 20% of first-trimester spontaneous abortions have
chromosomal abnormalities.
• c. Trisomy 21 is the most common trisomy in abortuses.
• d. Despite the relatively high frequency of Down syndrome at term,
most Down fetuses abort spontaneously.
• Ans.D. Despite the relatively high frequency of Down syndrome at
term, most Down fetuses abort spontaneously.
• Chromosomal abnormalities are found in approximately 50% of
spontaneous abortions, 5% of stillbirths, and 0.5% of live-born babies.
In spontaneous losses, trisomy 16 is the most common trisomy, with
45,X the most common single abnormality found. At term, trisomy 16
is never seen, and 45,X is seen in approximately 1 in 2000 births. It is
estimated that 99% of 45,X and 75% of trisomy 21 conceptuses are
lost before term.
• Ref. Williams Obstetrics, 26th Edition, Chapter 9
5
• A patient at 17 weeks gestation is diagnosed as having an intrauterine fetal
demise. She returns to your office 5 weeks later and her vital signs are: blood
pressure 110/72 mm Hg, pulse 93 beats per minute, temperature 36.38°C,
respiratory rate 16 breaths per minute. She has not had a miscarriage,
although she has had some occasional spotting. Her cervix is closed on
examination. This patient is at increased risk for which of the following?
• a. Septic abortion
• b. Recurrent abortion
• c. Consumptive coagulopathy with hypofibrinogenemia
• d. Future infertility
(AIIMS, 2019)
• Ans.C. Consumptive coagulopathy with hypofibrinogenemia
• Solutions:-
• In modern clinical medicine, once the diagnosis of fetal demise has been made, the products of
• conception are removed. If, however, the gestational age is more than 14 weeks and the fetal
• death occurred 5 weeks ago, coagulation abnormalities may be seen. Septic abortions were
more
• frequently seen during the era of illegal abortions, although occasionally sepsis can occur if there
• is incomplete evacuation of the products of conception in either a therapeutic or spontaneous
• abortion. However, since her cervix is closed and no tissue has passed, septic abortion is unlikely.
• Ref. Williams Obstetrics, 26th Edition, Chapter 59