Termination of pregnancy using vacuum aspiration.

This abortion technology is considered relatively safe, almost on a par with medication. Only failures in the form of incomplete abortion happen less with her. Another plus is a slightly larger allowable maximum interruption period. This is 7 obstetric weeks or 3 weeks from the onset of a delay in menstruation. In some cases, usually with a missed pregnancy, the procedure can be performed for longer periods.

Its advantage is that there is no need to expand the cervical canal with instruments and clean the uterine cavity with a curette. Accordingly, there is a small risk of inflammatory complications.

How everything goes. In a antenatal clinic or in a hospital, a woman is given local anesthesia. A thin disposable catheter is inserted into the uterus through the cervical canal, attached to a special apparatus with a container. After it is included in this container, the fetal egg, its membranes and endometrium are sucked off. The whole procedure takes about five minutes. If painful spasms of the uterus occur, intramuscular administration of an antispasmodic helps.

Termination of pregnancy by vacuum aspiration can have negative and very serious consequences, but rarely. This is perforation of the uterus, which can occur when measuring its length with a probe. And another complication is lethal, occurs due to a medical error - pneumoembolism. This is when not negative pressure is created in the uterine cavity, but positive. That is, air enters it, which instantly enters the bloodstream. Almost all newer vacuum aspirators are air protected.

Termination of pregnancy with pills.

Many women believe that this refers to those hormonal pills that are taken for the purpose of contraception, regular or emergency. For example, there is an opinion that the most famous means of emergency contraception, "Postinor", will work, even if it is taken while already pregnant. This is not so, medical termination of pregnancy in the early stages is carried out with the help of another drug - antiprogesterone, and it is impossible to buy it in a pharmacy in the dosage necessary for abortion.

Another feature of this type of abortion is the strict observance of the terms of its implementation. You need to have time to make an interruption up to 6 weeks, that is, two weeks of delay in menstruation. If you practice the medical method of abortion for a longer period, the consequences can be negative. Of course, complications can arise in case of full compliance with the deadlines, but their risk is much lower. The consequences include severe bleeding, provoked by the remnants of the membranes in the uterus. If this happens, vacuum aspiration or surgical abortion should be performed. This complication occurs in no more than five women out of 100 who perform medical termination of pregnancy. The rest have a complete miscarriage. But there are side effects, some are more pronounced, and some are less. This is an increase in blood pressure, nausea, vomiting, high body temperature, weakness.

How everything goes. After a small examination, including a mandatory ultrasound of the uterus and ovaries, the woman signs the consent to the procedure and confirms that she understands what complications may be. It should be remembered that after the first pills taken, it will no longer be possible to leave the child. Even if the fertilized egg continues to develop, and the drugs do not work or do not work completely.

The doctor will first dispense several antiprogesterone tablets, for a total of 200 mg. Their woman takes in the presence of her doctor. He stays at the clinic for a couple of hours and then goes home. Usually, a miscarriage does not occur immediately after taking antiprogesterone, the state of health does not worsen, although the drug itself begins to act actively. It binds to progesterone receptors, blocks the production of the hormone. This leads to the beginning of detachment of the fetal egg and the readiness of the myometrium for contractions.

After 36-48 hours, a woman in the clinic or at home (if the doctor gave her medication at home) takes a second medicine - prostaglandin. And after that, the expulsion of the fetal egg occurs, accompanied by the unpleasant symptoms indicated above. After a miscarriage, bleeding continues for several days, but the state of health becomes much better.

After 7-10 days, a control ultrasound is performed to make sure that the fetal egg and its membranes have left the uterus.

The advantages of this type of abortion is the absence of surgical intervention in the uterus. Due to the observance of the period up to which week, the medical method of abortion is allowed, a close relationship between the mother and the child does not have time to be established, hormonal disorders are also not too pronounced. Almost immediately after an abortion, a new pregnancy can occur. The menstrual cycle is restored after 28-30 days, usually without delay.

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.