Is medical abortion safe?

Medical abortion cannot be considered absolutely safe either - there are no such methods, since any abortion disrupts the course of the normal pregnancy process and roughly interrupts the hormonal changes that have begun in the woman's body preparing for childbearing. Of course, the shorter the gestational age, the less pronounced all the changes, but do not forget that hormonal changes begin immediately from the very beginning of pregnancy - the fertilization of the egg.

Therefore, even after medical abortion, the risk of developing diseases of hormone-dependent organs (mammary glands, ovaries, uterus) increases, and the likelihood of the formation of benign and malignant tumors of these organs increases. In addition, being an antihormonal drug, MEFIPRISTONE can cause a serious malfunction of the endocrine system, which can subsequently cause endocrine infertility.

Among the long-term consequences of abortions are various hormonal disorders, including diseases of the thyroid gland, pituitary gland - the central regulator of the endocrine system; gynecological pathology: endometriosis, ovarian dysfunction, chronic endometritis, salpingo-oophoritis (inflammatory process in the fallopian tubes and ovary), infertility. In subsequent pregnancies, an earlier abortion can provoke an Rh conflict - a condition in which antibodies are formed in the body of an Rh-negative mother to the red blood cells of an Rh-positive fetus.

The fact is, if during a pregnancy that ended in an abortion, a certain portion of antibodies has already developed, then these antibodies begin their detrimental effect on the fetus and during subsequent pregnancy with a Rh-positive fetus, others are added to them, that is, antibodies accumulate. The more antibodies, the more serious effect they can have on the body of the fetus.

So, if you become pregnant shortly after giving birth, remember that there is no safe abortion. Abortion is a serious blow to a woman's health and the price to pay for a careless attitude towards contraception and the prevention of unwanted pregnancies. Even with good subjective tolerance, abortion can cause serious long-term consequences, up to tumor processes, incurable infertility. Meanwhile, a second pregnancy will bring you new happiness - a second (and maybe third) child.

Are there safe abortions?

Why can a pregnancy interrupted even at the earliest stages be a serious blow to a woman's health? The fact is that from the very beginning, pregnancy causes serious changes, restructuring in many organ systems of the female body, primarily in the central regulatory systems - nervous and endocrine (hormonal). A close functional relationship between the mother's organism and the embryo appears from the very moment of fertilization. Even before the introduction of a fertilized egg into the wall of the uterus, the development of the embryo is influenced by hormones: estrogens, progesterone, prostaglandins and other biologically active substances. They also prepare the inner layer of the uterus - the endometrium - for implantation of the embryo. Under the influence of hormones and biologically active substances, a gradual restructuring begins in the entire body of the expectant mother, especially pronounced in the so-called hormone-dependent organs: mammary glands, ovaries, uterus, external genitalia.

Any external intervention leading to an abortion is the cause of a sharp hormonal breakdown in a woman's body. This explains the insecurity of abortion, carried out even at the shortest time. A significant mismatch in the work of the central nervous and endocrine systems, caused by external interference, disrupts the normal functioning of the endocrine glands: the pituitary gland, thyroid gland, ovaries, adrenal glands - and contributes to the occurrence of nervous disorders of varying severity: exacerbation of autonomic dysfunction, mental disorders, sometimes with the development of depression, neuroses, etc.

Consequences of abortions.

Even if we leave aside questions about the ethics of abortion, the problem of the consequences of abortion and the harm caused to women's health during artificial termination of pregnancy is obvious and relevant.

Abortion is the most common cause of gynecological diseases. Complications occur in at least every fifth woman, almost half of chronic inflammatory processes of the genital area become aggravated. There is also a danger that abortions performed “on the day of treatment” do not involve any preparation - the examination is minimal, if any. At the same time, the very procedure of abortion by any of the listed methods contributes to the development of infectious and inflammatory complications. If antibiotics are prescribed during an instrumental abortion performed in a hospital, then with medical termination of pregnancy, the use of magnetic caps, antibiotic therapy is not always carried out. With the spread of infection, inflammation of the uterus and appendages, pelvic peritonitis, thrombophlebitis (inflammation) of the veins of the uterus, or general blood poisoning - sepsis can develop.

A distant consequence of inflammatory diseases transferred after an abortion can be the formation of adhesions, including intrauterine (synechia), obstruction of the fallopian tubes, which is one of the causes of infertility; chronic inflammatory processes that disrupt the normal functioning of the organs of the female genital area.

Traumatization of the cervix during abortion in the future may cause her inability to "keep" the pregnancy. Thus, miscarriage, miscarriage, or - due to cervical deformity - disruption of normal labor can develop.

One of the most common consequences of an abortion is a menstrual cycle disorder (it occurs in about 12% of women), the cycles become irregular, bleeding between periods is possible. The cause of these conditions are, as a rule, neuroendocrine disorders, amenorrhea develops, i.e. lack of menstruation, resulting from a violation of the regenerative ability of the endometrium - the inner lining of the uterus (when a pregnancy is terminated with curettage of the uterus, not only the removal of the fetal egg often occurs, but also the traumatization of the deep layers of the endometrium, as well as the muscle layer of the uterus) with subsequent inhibition of ovarian function, which leads to violation of the menstrual cycle, as well as the development of adhesions in the area of ​​the internal pharynx of the cervical canal due to its traumatization.

In the case when an abortion was made by a woman giving birth, her cycle can be restored in 3-4 months; if the woman did not give birth before the operation, the restoration of all functions can be delayed up to six months or more.

Instrumental abortion (curettage of the uterine cavity).

This is the most common way to terminate a pregnancy up to 12 weeks. Currently, instrumental abortion is performed under anesthesia: more often - using intravenous anesthesia (a drug is injected into the vein, against the background of which there is an instant - "at the end of the needle" - sleep), less often - epidural anesthesia or general endotracheal anesthesia (an inhalation drug is administered through tube into the trachea).

The method of anesthesia is determined by the anesthetist, depending on the individual indications and contraindications for the patient. The cervix is opened with special dilators (tubes of various diameters), then a curette (metal loop) is inserted into the uterine cavity, which is used to scrape the uterine cavity. The risk of instrumental abortion complications is reduced if ultrasonic control with a vaginal probe and an examination of the uterine cavity with a hysteroscope (a special optical device) are performed before and after the procedure. However, instrumental abortion is a surgical procedure that uses anesthesia, so complications cannot be completely ruled out.

A rare but most dangerous complication of curettage of the uterine cavity is perforation of the uterine wall with penetration into the abdominal cavity. Severe bleeding, peritonitis (inflammation of the peritoneum), trauma to the abdominal organs can cause death.

Early complications after abortion include bleeding, disorders of the blood coagulation system. Sometimes blood clots accumulate in the uterine cavity due to cervical spasm, which may require repeated curettage.

Mini abortion (vacuum aspiration).

This method of abortion is applicable only in the early stages (up to 5-6 weeks of pregnancy), when the diameter of the fetal egg allows it to pass into the vacuum aspirator. A vacuum aspirator is a large syringe with a special nozzle that is inserted into the uterine cavity to the fetal egg. The created vacuum contributes to the exfoliation of the fetal egg from the uterine wall. However, the probability of incomplete separation of embryonic tissues with this method of abortion is very high. Therefore, after a mini-abortion (however, as with other types of abortion), ultrasound control with a vaginal sensor is necessary. If an incomplete abortion of the fetal egg is detected, additional curettage is required, similar to what is done with a conventional instrumental abortion. A mini-abortion is carried out against the background of general anesthesia: a medicine is injected intravenously, the woman sleeps.

For very short periods, it is possible to use a magnetophoric (magnetic) cap, which is put on the cervix. The cap emits a constant magnetic field, which distorts all signals that fall into its field. The connection between the uterus and the brain is broken. Pregnancy ceases to develop, a miscarriage occurs. The magnetic cap is put on by the gynecologist for 9 days. After this period, the doctor removes the cap, inserts pills into the vagina that help open the cervix. After that, already outside the walls of the clinic, an abortion occurs. This method is dangerous undetected complications. A cap inserted into the cervix contributes to circulatory disorders in the cervix, the development of inflammatory processes in the uterus. After termination of pregnancy, ultrasound control is required.

Medical abortion.

The most commonly used medication for abortion is MEFIPRISTONE (MIFEGIN, RU486). This drug interferes with the action on the uterus of the main hormone of pregnancy - progesterone, thereby contributing to its interruption. Usually, MEFIPRISTONE is used against the background of small doses of drugs that increase uterine contractions and rejection of the fetal egg from the body - prostaglandins.

Medical abortion is performed at gestational ages up to 8 weeks and in cases of uncomplicated course does not require surgical intervention and anesthesia. Before medical abortion, a woman undergoes an ultrasound examination. Further, after signing the informed consent, the pregnant woman, in the presence of a doctor, takes 3 tablets of the drug, after which she can leave the clinic. Usually, after 1-2 days, bleeding begins, similar to menstrual bleeding and indicating an abortion and rejection of the fetal egg. After a medical abortion, it is recommended to conduct a second ultrasound to make sure that there are no remnants of the ovum in the uterine cavity, which can become infected, cause severe bleeding and other post-abortion complications.

If there are alarming complaints (sharp pain, fever, chills, very severe bleeding with severe weakness, dizziness, malaise, etc.), you should immediately consult a doctor or call an ambulance. In such cases, surgical intervention is often required - curettage of the uterine cavity, i.e. in fact, carrying out a routine abortion. As with other medicinal methods, there are a number of contraindications to medical abortion:

• Ectopic pregnancy - it requires only surgical treatment.

• Chronic adrenal insufficiency and severe bronchial asthma, since MEFIPRISTONE disrupts the action of adrenal hormones, which are also used to treat asthma.

• Infectious and inflammatory processes of the genital tract (to avoid the spread of infection).

• Hemorrhagic disorders (blood clotting disorders) - due to the possibility of heavy bleeding. Termination of pregnancy in such cases should be carried out only in a clinical setting under constant medical supervision and monitoring of blood coagulation.

In 2% of cases, medical abortion is ineffective - the drug does not cause an abortive effect and the pregnancy is not interrupted.

Safe abortion?

After childbirth, often young mothers, focusing on the absence of menstruation, mistakenly relying on the contraceptive effect of breastfeeding, face the problem of another pregnancy. In this situation, a woman chooses an abortion, thinking that this is a fairly harmless event, and if an abortion is done at an early date, then there can be no talk of any danger at all. But is it really so?

Abortion is the termination of a pregnancy up to 22 weeks. Abortions are spontaneous (miscarriage) and artificial (by surgical or other intervention). Depending on the term of termination of pregnancy, artificial abortions are divided into early (termination of pregnancy for up to 12 weeks) and late (for more than 12 weeks). Abortions up to 12 weeks are performed at the request of the woman. At a later date, the decision on abortion based on the application of the pregnant woman is made by a commission that takes into account the available indications - medical (threat to the woman's health, severe malformations and non-viability of the fetus) and social (death or disability of 1-2 groups of the husband, large families, lack of housing, refugee status , unemployment, rape, unmarriage).

What should be kept in mind when choosing the type of abortion?

In order for a woman who wants to get rid of an unplanned pregnancy to have an alternative when choosing an abortion method, you need to remember a few things.

The shorter the gestational age, the more likely it is that the abortion will take place with minimal consequences. Therefore, you need to contact a gynecologist in the first days of the delay in the menstrual cycle. This will allow timely assessment of the state of health of the woman and choose the most appropriate method of termination of pregnancy for her.

Do not trust advertising and advice from friends. So, for example, pills for medical termination of pregnancy can be bought at a pharmacy. This is where the danger lurks - if they suddenly do not fit a woman or the rejection of the fetal egg does not happen correctly, then even in the early stages you will have to resort to a surgical abortion. Yes, and a hormonal failure, the occurrence of which could be predicted during the testing and examination of a medical record by a gynecologist, can cause great harm to a woman's health.

When choosing an abortion method, one should not forget about such important things as the equipment of the clinic and the qualifications of the doctor.

The birth of a baby is a long-awaited event in the life of most women. However, there are situations when the continuation of pregnancy is undesirable for medical or other reasons. And a qualified gynecologist should become a faithful adviser in such a situation, able to correctly assess the state of health of his patient, and then individually select the most gentle method of abortion for her.

Termination of pregnancy at a later date.

If in the early stages of pregnancy a woman and her gynecologist are given the choice of resorting to a medical method or vacuum aspiration, then for a period of 7-12 or more weeks, as a rule, saline abortion or surgical termination of pregnancy remains.

The first involves the introduction of a special hypertonic sodium chloride solution into the amniotic fluid, causing the death of the fetus. After a couple of days, the doctor provokes a contraction of the uterus, as a result of which the fetal egg is naturally excreted. It should be noted that such a procedure is not considered highly effective and also differs in duration. Therefore, saline is used extremely rarely - if it is impossible to use another, more effective method.

The most common way to get rid of an unwanted pregnancy for a period of 7-8 to 12 weeks remains curettage with a curette. Such an abortion should be carried out only in a hospital, by an experienced doctor, and preferably with the simultaneous use of ultrasound. As a rule, the procedure is performed under local anesthesia, less often - mainly at the request of the patient under general anesthesia.

The gynecologist mechanically - using special tools - expands the wall of the uterus, then, using a curette and forceps, scrapes and removes its contents. Risks: the cervix and walls of the uterus often suffer from mechanical impact, which subsequently leads to inflammatory processes, the development of gynecological diseases, including infertility. Moreover, the longer the gestational age, the more likely complications after an abortion.

Abortion for a period of 12 or more weeks is carried out only for medical reasons, and after 22 weeks, surgical intervention during pregnancy is called artificial premature birth or a small caesarean section. During the latter, the patient is dissected the lower segment of the uterus and the fetal egg is removed from it along with the placenta. A similar method is also used if sterilization is expected after an abortion.

Abortion using a vacuum device.

Usually they resort to it if no more than 5-7 weeks have passed since the moment of conception. This method is also considered the least traumatic for the female body, since the fetal egg is sucked out of the uterus through a special catheter probe connected to the pump of the vacuum apparatus.

The advantages of vacuum aspiration (popularly a mini-abortion) are obvious: a thin probe that is inserted through the cervix without dilating it does not injure the female organs at all, and the rejection of the fetus, which still has weak connections with the walls of the uterus, occurs due to the creation of a negative pressure. It is only important not to miss the deadlines and in the future to make sure that the fetal egg is completely extracted.

Modern technologies make it possible to carry out vacuum aspiration with virtually no consequences for the female body. However, this procedure has a number of contraindications:

• less than six months have passed since the previous abortion - any;

• ectopic pregnancy;

• the gestation period is more than 5 weeks (maximum - 7) - in this case, the fetal egg is already firmly attached to the walls of the uterus, which greatly complicates its exfoliation and suction;

• a woman suffers from any inflammatory diseases, including a purulent infection of any part of the body.

The whole procedure is performed under local anesthesia - general anesthesia is resorted to only in exceptional cases - within 10-15 minutes. A woman can go home almost immediately. Next - personal hygiene and a visit to the gynecologist at the appointed time.