MTP -ACT

OVERVIEW
• RATIONAL
• MTP ACT
Indication
Recommendation
• Methods of termination
Medical
Surgical
• MTP Complication
 MTP ACT
• India- legalised
• 1971- Act
• Enforced- 1972, revised- 1975
• MTP- Deliberate termination of pregnancy
medical or surgical method before viability
 Indication
• Medical
• Social
• Eugenic
• Rape/ contraceptive failure
 MTP- Recommendation
• Who is to perform
Assisted-25 MTP(authorised center/certificate
6 Months- house surgeon-(OBG)
Diploma/Degree- OB

• Where to perform
Govt hospitals/ approved by govt

• Upto when
12Weeks- 1 RMP
20 Weeks- 2 RMP
 prerequisite
• Maternal consent
• Lunatic/ below 18 yrs - guardian consent
• Confidential reporting – DGHS( format)
 Methods- MTP
l ST TRIMESTER(< 12 w)
Medical
Mifepristone

Mifepristone& misoprostol (9 weeks)

200mg/ 48-72 hrs- later misoprostol
10-14 days review
complete- 95%, Incomplete 2%

Methotrexate/ Misoprostol(8 weeks)

50mg/sqm
• Surgical
Menstrual regulation
Suction evacuation
Dilatation & evacuation
 MTP

• Second trimester
Medical
Misoprostol-(mean abortion time12hrs)
400-800 micro/ 6-8 hrs(4 doses)
Almost 100 percent success
Gemeprost -1mg vag pessary/6 hrs/5doses
Mifeprisone/ miso – combination
PGF2 Alpha- 250 micro/max10 doses/3hrly
High dose- oxytocin
 MTP
• SURGICAL METHODS

Intramniotic
Hypertonic Saline(20%)/ Urea
90-95% success
Action- prostaglandin release
Extra amniotic
0.1% ethacrydine lactate (10 ml/week)

Hysterotomy
 Complication
Immediate
• Surgical

cervical laceration
Hemorrhage, uterine perforation, thrombosis

• Medical
Nausea, vomiting, diarrhoea , water
intoxication, hypernatremia ,DIC, shock

late

PID, Menstrual disturbance, continuation of pregnancy