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DESCRIPTION OF TECHNIQUES USED FOR INTRODUCING induced abortions


Abortion can be done in a public hospital or private are the same techniques, patterns of organization or the host may be different.

If the pregnancy is dated from 7 to 14 weeks from the beginning of last menstrual period (we say "LMP"), use the technique of aspiration of uterine contents, under general or local anesthesia, in both cases the technique aspiration will be the same.

If the pregnancy is dated 7 weeks of gestation or less: a woman may receive a method of abortion by medication.

ANESTHESIA

I-General anesthesia.



The patient is completely asleep and hospitalized 6 to 12 hours.
This is a short (fifteen minutes) but a real anesthesia and every precaution must be taken:
- Consultation with the anesthetist before the procedure, it should be noted tobacco habits, allergies and asthma.
- Be strict fasting the morning of surgery, do not smoke.
- Place one or two hours in the recovery room before returning to bed without eating or drinking.
- Be accompanied when returning home.

II-Local anesthesia

It is the operator which takes care of the anesthesia must tell him if there are allergies or episodes of convulsions.
The woman was conscious during the procedure, she was hospitalized about two hours, but it does not suffer can feel unpleasant (heart beating fast, malaise, trembling symptoms give way quickly and spontaneously).

The physician makes a speculum into the vagina (this unit allows you to view and access the cervix), and it injects the anesthetic in the neck which is the most sensitive part.

He will wait 2-3 minutes before the abortion the patient can ask questions or tell him of any event or feeling it seemed unexpected.

ASPIRATION

30 years of medical experience and aspiration of more frequent use of abortion drugs have made abortion not dangerous complications are rare, someone from the host team can provide details on this subject.

In most cases a drug is administered cervical dilator is 48 hours or 4 hours before surgery, this is intended to facilitate the expansion which is the most painful moment of the intervention: it will be easier and faster, what is best for the patient and operator.

The duration of the intervention is a quarter of an hour to 20 minutes.

The technique is the same whatever the type of anesthesia.

I - When the woman is asleep or local anesthesia once made, the expansion begins:
It is moving in the neck that is visible probes rubber or plastic of increasing size until a diameter that varies depending on the term of pregnancy.

II - The operator then passes a hollow tube into the uterus, and connects to a device to create a vacuum and will displace the cannula gently, that the woman may feel: When the uterus is empty pain like a sharp pain rule can be felt because the uterus is not fully anesthetized, it lasts a few seconds.

After surgery under local anesthesia, the patient can regain bed on her own and can sustain themselves quickly.

The output can be faster if all goes well (1-3 hours after surgery).

Postoperative monitoring:
Bleeding is unimportant due to aspiration, in case of bleeding, pain or fever after the release, notify the operator or the service.

ABORTION BY MEDICINE:

This technique is very different because nonsurgical, it looks like the unfolding of a spontaneous miscarriage but faster and more efficient. Following the consultations that led to the accurate diagnosis of the term and clarify the patient's choice of method, abortion occurs in 48 hours

Day 1:
Taking three tablets abortifacients (the Mifegyne) at the hospital, and then restarts the woman about her business.
Abortion begins by peeling the egg (the "egg" is composed of tissues that function schedules for nourishing the embryo (usually invisible) which is inside).

Day 2:
It happens little day 1 and 2 (sometimes a few cramps and fatigue, bleeding is often abundant as rules or more, the woman can go about their usual activities;

Day 3:
The woman spends 3 to 4 hours at the hospital because we will give him the medicine that will cause contractions (prostaglandin) and empty the uterus.

This causes bleeding sometimes more important than rules and contractions more or less painful, it is a rest period and monitoring, but it is useless to stay in bed (the habits of services vary widely); staff Nurses are there to support and reassure or satisfy a need to treat the pain side effects are inconstant nausea or vomiting, rarely diarrhea.

Abortion can occur within three hours after prostaglandin administration, or later, once back home. Among the clots are expelled can sometimes see the egg, 1 to 3 cm in diameter and white and transparent appearance.

Anyway this is the ultrasound examination and the 10th day or a dosage of hormones which control the success of the procedure (95 to 98% complete abortions).

Prospects for improvement of the method:
- It is conceivable that, for early pregnancy (less than 7 weeks gestation), the woman can take the tablets prostaglandin at home on days 1 and wait quietly after taking the day No. 3 that abortion is made on condition that it is his choice, it is comfortably installed and on the phone with the service manager.
- We can also predict the drug use of the technique up to 9 weeks gestation (in this case the efficiency is then somewhat less, 90% of pregnancies evicted) but in this case monitoring in the hospital is strongly recommended because abortion is more painful and bleeding.
         
Things to know:

There is not a better way than the other but must be determined with the doctor that is possible and that will fit every case.

Suction and drugs are equally effective.

All women are not equal before the pain, it depends on their history and their emotional state, if the woman wants to "see anything", it is preferable to choose general anesthesia, the medical method will avoid the surgical procedure but requires a bit more accountability and time it has its drawbacks (waiting, pain, prolonged bleeding).

Some recommendations will be made in the outlet or baths or swimming for a week.

In all cases sexual intercourse can be resumed from 6 to 10 days after the abortion, contraception, so plan a day immediately after the abortion.