Today, there are several methods of terminating pregnancy. These interventions are carried out both at the request of the woman and in the presence of conditions and diseases in which the consequences of pregnancy can aggravate their course. Medical abortion is considered the newest and least traumatic.
Medical abortion is the termination of pregnancy using tablets.
Not a single procedure leaves its mark on the body. But there are methods that have little impact. Medical abortion is the least dangerous method and rarely causes complications. But sometimes they happen. Therefore, when using it, it is necessary to monitor your health in order to early diagnose side effects.
Classification
All consequences after medical termination of pregnancy are divided into:
- Frequent.
- Rare.
The most common manifestations include:
- Nausea, vomiting.
- Indigestion.
- Delay of menstruation not exceeding four days.
- Stomach ache.
Rare consequences of medical abortion are:
- Head pain and dizziness.
- Change in blood pressure.
- Uterine bleeding.
- Infectious and inflammatory diseases of the genital organs.
- Allergic reactions.
The most rare manifestations, which occur one case in 10,000, include: Quincke's edema, uterine rupture and infectious-toxic shock.
Uterine rupture occurs as a consequence of medical abortion only if the woman has previously had surgical interventions on it, or during an ectopic pregnancy. The cause of the appearance is a violation of the coordinated contraction of the uterus.
According to the time of occurrence of the consequences of medical termination of pregnancy, the following types are distinguished:
- Short term.
- Medium term.
- Late.
Short term consequences
This concept unites a whole group of consequences of the medical method of abortion, which occur immediately after taking abortion medications.
The most common early consequences of medical abortion are:
- Nausea.
- Vomit.
- Weakness.
- Loss of appetite.
- Dizziness.
- Allergic reactions.
These symptoms are explained by the systemic effect of the drugs on all systems of the woman’s body.
If vomiting occurs immediately after taking the medication, you must re-take an identical dose.
Allergic reactions occur quite rarely. Its manifestations can be varied. From simple rashes on the skin and mucous membranes to symptoms of other serious conditions: swelling of the nasopharynx, difficulty breathing. If they occur, you should immediately consult a doctor.
To prevent their occurrence and provide timely medical care, doctors recommend staying in the hospital while taking the first doses of drugs.
Medium-term complications
Consequences of medical abortion, which require a short period of time to develop. Its duration varies from person to person. It varies from several hours to several days.
The appearance of these symptoms indicates the effect of the components of the drug on the fertilized egg and reproductive organs in order to provoke its expulsion from the woman’s body.
Medium-term consequences after medical abortion:
- Intense abdominal pain.
- Violation of the act of defecation.
- Digestive disorder.
- Increased body temperature.
- Bleeding.
- Accumulation of blood clots in the uterine cavity.
Abdominal pain is associated with uterine spasms. Their intensity can vary: from moderately painful to strong and painful. The duration of pain is individual; it can bother a woman from several hours to several days. Doctors do not recommend the use of antispasmodic drugs, as they reduce the contractile activity of the uterus, causing incomplete abortion. For unbearable pain, it is possible to use drugs from the group of non-steroidal anti-inflammatory drugs, based on ibuprofen.
Bleeding that occurs in response to taking the drug is a natural process. With its help, the fertilized egg is expelled from the uterine cavity. The intensity and duration of bleeding varies from woman to woman. But you should be wary and, if necessary, consult a doctor if you have to change the pad twice in three hours, or the discharge acquires an unpleasant odor.
In some cases, it is possible that the fertilized egg does not leave the uterine cavity. Experts call this condition incomplete abortion, if the growth of the embryo stops, or the pregnancy continues.
The cause of these complications is incorrect calculation of the dose of drugs. The main diagnostic method is ultrasound examination of the pelvic organs (ultrasound). It is usually prescribed within a few days after stopping taking abortifacient pills. In case of incomplete abortion, the main method of treatment is curettage of the fertilized egg from the uterine cavity. Since the drugs have a negative effect on the child and the woman’s reproductive organs, a continuing pregnancy is an indication for its termination by other methods.
The mid-term consequences of medical abortion are of greatest concern to women. And it is they who sometimes require additional medical intervention.
When this type of abortion is performed in the early stages, the likelihood of complications occurring is negligible.
Late consequences
As a rule, they are thought about very rarely. But it is these complications that arise after several months and even years that change a woman’s quality of life for the worse. Most of them cannot be corrected or treated. According to statistics, the likelihood of late consequences of a medical abortion is quite low.
The most common complications arising in the delayed period:
- Hormonal disorders.
- Inflammatory diseases of the pelvic organs.
- Infectious diseases of the genital organs.
- Infertility.
Changes in hormonal balance occur in response to drugs used for abortion. These medications contain a powerful dose of various artificially created substances. They affect not only the fertilized egg and reproductive organs, but also all hormone-producing organs, causing disruption of their function.
The main symptoms to suspect the occurrence of inflammatory and infectious diseases:
- Increased body temperature.
- Weakness.
- Malaise.
- Pain in the lower abdomen.
- Discharge from the genital tract with an unpleasant odor.
With these manifestations of the disease, it is necessary to contact a gynecologist for proper diagnosis and treatment.
In response to hormonal changes or infectious and inflammatory complications, infertility may occur. Correcting this condition is, in most cases, labor-intensive work. This consequence is most frightening for women of reproductive age.
It is worth remembering that any intervention is always extremely likely to result in various consequences. To minimize their occurrence, you should consult a gynecologist. After deciding whether to use a medical abortion, you should strictly follow the doctor’s instructions for using abortifacient drugs.
Preparation includes a smear for flora and an intravaginal ultrasound to determine the gestational age and location of the fertilized egg. It is also clarified whether the woman has chronic diseases, which may become contraindications for medical interruption. Before the procedure, do not eat anything salty, fatty, or smoked; after a medical abortion, you should not take a bath or go to the pool until everything is over. You cannot eat 3 hours before the interruption and less than 2 hours after.
The effectiveness of medical abortion
Medical termination of pregnancy manifests itself as more painful periods than usual. Interruption efficiency is 95%. The advantage of a medical abortion is that it does not require general anesthesia. You simply get a pill and take it in front of a doctor. After 72 hours, you go back to the clinic where you are given a pill to contract your uterus. A day later, heavy bleeding begins.
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Timing of medical termination of pregnancy
Duration of medical termination of pregnancy: 5-6 weeks. Medical abortion is performed after a complete gynecological examination. Side effects: nausea, headache. Contraindicated for heart defects with severe heart failure, tuberculosis, hypertension and fibroids, obesity and diabetes.
How is medical abortion performed?
Medical termination of pregnancy begins with a preliminary conversation between the woman and the doctor. She is informed about possible contraindications and complications and the very essence of the method. Next, they take blood tests for HIV, hepatitis, Rh factor and a smear for flora and do an ultrasound to clarify the date. The woman signs the consent.
As for pain, it all depends on the period: the longer the pregnancy, the more intense the pain.
After a medical abortion, a woman is given contraception. Conception can occur immediately, so you need to start using protection immediately.
Stages
In any case, a woman goes through the following stages of medical abortion:
- A woman calls the clinic and makes an appointment with a doctor, indicating that she wishes to have a medicated abortion. Food is not taken 3 hours before.
- At the appointment, the doctor performs an ultrasound.
- You are warned about possible complications of the procedure and contraindications to it, and have an introductory conversation.
- Together with your gynecologist, you choose one of the drugs produced in France or Russia.
- Tests may also be ordered if you did not have them shortly before the interruption. Results are ready in 1 day.
- The drug is taken under the doctor's supervision.
- Within 72 hours, pain and discharge similar to menstruation appear.
- After the onset of pain and bleeding, prostaglandins are taken. Within 5 days, the fertilized egg comes out entirely.
- The next stage is a control ultrasound.
Remember that the vagina is home to bacteria. This is why pap smears are done before a medical abortion. When the cervix dilates, bacteria can enter the uterus. Unfortunately, sometimes toxic shock occurs with a fatal outcome, but this is stubbornly kept silent about.
Choose a clinic whose doctors have been performing medical abortion procedures for a long time. This will help keep complications to a minimum.
Tablets for medical abortion
Tablets for medical abortion: Mifepristone, Mifegin, Mifeprex, Mifolian, RU-486. The active ingredient of all these drugs is Mifepristone. This is a complex molecule that has a complex effect on the female body, which is determined to maintain pregnancy. If you had an irregular menstrual cycle before taking the pill, the problem may get worse.
Medical abortion is carried out with drugs that include Mifepristone: Mifegin, Mifeprex, Mifolian, RU-486. Specialists always carefully prepare a woman for taking these drugs. The doctor discusses with the patient the medical history, all the diseases that she had or has.
Mifepristone
Mifepristone blocks receptors for the hormone that supports pregnancy.
Medical termination of pregnancy with mifepristone is better tolerated than surgery. Before the procedure, you confirm that you are aware that in the future a surgical abortion may be required due to incomplete removal of the fertilized egg. After taking mifepristone, on the 2nd day you come back to the clinic and take another drug that expels the embryo within 1 hour. The bloody discharge continues for 10 days, after which you come for a follow-up ultrasound. In isolated cases, after taking the drug, diarrhea, dizziness and nausea are possible.
Mifepristone has the following contraindications:
- Pregnancy while using an intrauterine device.
- Scar after cesarean section.
- Leiomyoma.
- Kidney and liver failure.
- Blood clotting disorder.
- Anemia.
- Asthma.
- Diseases of the female genital area.
After taking it, you may experience severe pain in the lower abdomen, dizziness and vomiting. The temperature may rise significantly. Do not take any painkillers or antipyretics - they can stop the abortion. You can take analgin or no-shpa as a last resort. It's better to call the doctor who performed the abortion. You will be given emergency numbers where you can get advice. If for some reason you cannot contact this doctor, call an ambulance if you have severe pain, persistent vomiting and fever.
Mifegin
Medical termination of pregnancy using mifegin is an alternative to curettage. Unsuccessful result, incomplete extraction of the fertilized egg is possible in 5% of cases.
Mifegin is a progesterone antagonist. The mucous membrane of the uterus, under its influence, begins to be rejected. Abortion with pills is a serious intervention in the body; it cannot be called completely harmless.
The first visit to the doctor includes an examination in the chair, a consultation with the patient, signing the appropriate paper - consent to an abortion, an ultrasound to confirm the term and the first dose of pills. The next visit should take place in 72 hours. During this visit, prostaglandin is used to expel the fetus from the uterus. In the clinic you need to be under observation for 1.5 hours. If the pain is very severe, you may be given no-shpa. Brief diarrhea may occur.
After 12-16 days you need to do an ultrasound. If for some reason the pregnancy continues, a regular abortion is performed.
Between visits, you cannot visit the sauna or drink alcohol.
Pencrofton
Medical termination of pregnancy with Pencrofton is an alternative to surgical abortion. Advantages of medical abortion using the Russian drug Pencrofton:
- Early termination of pregnancy on the second day after conception (for example, if you are a victim of violence).
- There is no danger of contracting hepatitis, as happens during an abortion, if the instruments are poorly sterilized.
- Lower cost.
- Curettage can cause a scar on the uterus or perforation, life-threatening bleeding. This does not happen when taking Pencrofton.
- Fertility is immediately restored.
- No anesthesia needed.
- No need to go to the hospital.
- The risk of depression after an abortion is reduced.
The drug was developed in 1990. It expels the embryo from the uterus, dilating the cervix. Abortion of pregnancy with Pencrofton is possible up to 7 weeks. It can only be used in clinics. The patient is given 3 tablets once and goes home. Then, after 72 hours, she is given a drug that expels the fetus, which has stopped developing during this time. After 16 days, an ultrasound is performed and curettage if necessary (this happens rarely).
When taking Pancrofton, there are a minimum of side effects, as a rule, these are only nausea and a feeling of weakness, a slight increase in body temperature for 4 hours.
Misoprostol
Medical termination of pregnancy with misoprostol in Kyiv can be done in many specialized clinics. Misoprostol is the latest generation abortion drug. As a result of the work of the uterine muscles under its action, the fertilized egg is pushed out.
The method eliminates psychogenic trauma and is best suited for young nulliparous girls.
Abortion after 1-15 days occurs in 65-85% of cases. The introduction of a prostaglandin analogue after 1-3 days increases this figure to 88-98%. The same results were obtained using Pencrofton. Thus, the optimal regimen for carrying out a medical abortion procedure today is 600 mg of mifepristone with the introduction of prostaglandins after 36-72 hours.
Duphaston
Duphaston after medical termination of pregnancy is prescribed in the post-abortion period. On day 16, after an ultrasound, Duphaston is prescribed 10 mg twice a day for 10 days. Duphaston is an active progestogen. It is used for a number of gynecological diseases. When taking it, there are no unwanted hormonal disorders. Duphaston does not affect liver cells and blood pressure.
Along with Duphaston, the gynecologist may prescribe you multivitamins or special vitamin complexes that are used in stressful situations. Abortion, surgical or medical, is stressful for a woman. As a result, not only the nervous system, but also the heart can suffer. Sometimes post-abortion psychosis develops. The first reaction is always relief. But then the woman often experiences remorse, her self-esteem decreases, and on this day every year she may cry. Understanding what happened helps. You can mourn your child. The support of loved ones is very important, but, unfortunately, the husband cannot always understand why his wife suddenly became cold towards him. The process of finally getting rid of guilt can be long. Medical termination of pregnancy is usually easier for women to tolerate and does not have such a strong impact on their state of mind.
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Consequences of medical abortion
The consequences of medical termination of pregnancy are mainly reduced to nausea, diarrhea and delay of menstruation up to 12 weeks, headache, chills, endometritis. Side effects such as angioedema, uterine rupture and toxic shock are extremely rare. Toxic shock can lead to death.
Pregnancy is not interrupted in 3% of cases. Then you have to do scraping. As a result, inflammatory diseases can worsen, adhesions and infertility develop - not immediately, sometimes a woman becomes pregnant and gives birth, but the inflammation worsens several times and leads to infertility.
During pregnancy, the nervous system is rebuilt. The body is configured to carry a pregnancy. Medical abortion artificially stops this process. That is why neuroses, the so-called, are so common. post-abortion syndrome. Thyroid diseases are rarely associated with medicinal abortion, explaining everything with the Chernobyl accident. But in vain. The thyroid gland takes part in the regulation of hormones that support pregnancy, although not as clearly as the ovaries and pituitary gland. It is clear that people go for an abortion out of desperation and a sudden collapse of plans. But if you think about it, there are no safe abortions. Most of us have carious teeth, tonsillitis or rhinitis. These are infectious foci. After an abortion performed by any method, a woman’s immune system sharply weakens. Harmful bacteria from the vagina can enter the uterus. The risk of getting an infection from the vagina is especially high, because it is located closest, but theoretically, through the bloodstream, the infection can get inside the uterus from any source in the body, even a carious tooth.
Of course, the listed consequences most often occur during surgical abortion. But even with a medical abortion, the cervix dilates when the fertilized egg is expelled. Infection easily penetrates through these gates.
To ensure minimal consequences, a medical termination of pregnancy should end with rest for your body. Do not exercise for a month, do not have sexual intercourse, take a shower or swim in open water, do not go to the sauna, swimming pool, or take a bath earlier than 3 weeks after a medical abortion.
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Harm
The harm of medical abortion is caused by blocking progesterone receptors. There is no trauma to the uterus, so complications are much less common than with a traditional abortion. A common complication is incomplete expulsion of the fetus (about 10%). Prolonged uterine bleeding is possible. There are known cases of toxic shock after taking “pregnancy pills.”
Complications
It is rare, but still possible, to experience serious complications after a medical termination of pregnancy. First of all, this is the lack of effect of the drug or incomplete abortion. Menstruation may also become irregular or very heavy. Possible allergies. If any alarming signs appear, you should immediately seek advice from the clinic where the abortion was performed.
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Discharge
Discharge after medical termination of pregnancy is usually brownish, with blood, and is often disturbing even if the heavy bleeding has already stopped. To remove all suspicions, be sure to visit a gynecologist and do an ultrasound on days 14-16 after the abortion. If, a month and a half after a medical abortion, the discharge does not stop, this indicates that there has been a failure in the hormonal system. To correct this condition, the doctor may prescribe oral contraceptives (mini-pills or combination pills).
You should also pay attention to yellow discharge. This may be a sign of purulent inflammation that has developed due to the fact that you have been carrying a dead child inside you for some time. Yellow discharge after a medical abortion may be a sign of E. coli overgrowth.
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Bleeding
Medical termination of pregnancy is considered the safest method, but this does not mean it is harmless. Sometimes it happens that after an abortion, heavy bleeding develops. It can lead to life-threatening blood loss. In this case, you need to lie down and call an ambulance, without hiding the fact that you had a medical abortion. Light bleeding, no more than menstrual bleeding, is considered normal until the onset of menstruation after a medical abortion. If you have to change more than one nightcloth in an hour, seek medical attention.
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Pain
Pain after medical termination of pregnancy varies in intensity for each woman. They are caused by contraction of the uterine muscles. How severe the pain will be depends on the pain threshold and stage of pregnancy. Painkillers for unbearable pain should be prescribed by a doctor because many of these drugs can inhibit pregnancy loss. Pain after a medical abortion lasts for two days. Pain that is slightly more intense than normal period pain is considered normal. Several menstrual cycles can also be painful. A gynecologist may prescribe you a course of physiotherapy or gynecological massage if the pain and bleeding are very intense and prolonged. To avoid the development of infection in the uterus, a control ultrasound on the 16th day must be done, even if you have no complaints. Abdominal pain, fever, green and curdled discharge are all signs of an infection. Medical termination of pregnancy, done according to all the rules, in three visits, rarely leads to such consequences. 98% of complications during medical abortion are associated with ignoring medical recommendations.
Temperature
The temperature after medical termination of pregnancy usually rises no higher than 37.5ºC and lasts no more than 4 hours. Temperatures up to 37.2C can last for about 10 days. It is associated with increased progesterone levels. Delaying treatment of a possible infectious process in the uterus leads to infertility. Blood clots and fever, excessive bleeding should be a reason to conduct an ultrasound examination of the pelvic organs before the time prescribed by the doctor (usually 14-16 days after the abortion). If you have a fever and malaise after the abortion, call your doctor home.
Nausea
Nausea after medical termination of pregnancy is not observed in all women and does not last long. If you vomit within an hour of taking the drug, unfortunately, the pills will not work. You will be referred for a vacuum abortion.
If a woman is very bothered by pain in the lower abdomen, she may be prescribed no-shpa. Aspirin should not be taken. For nausea you can take Cerucal. It has an antiemetic effect by blocking receptors. The maximum concentration of the drug is reached after 30 minutes. The half-life is 5 hours. Adult dose - 10 mg 3 times a day. Possible side effects: headache, increased fatigue, fear, tachycardia, itching. Contraindications: individual sensitivity, intestinal obstruction, epilepsy.
Recovery after medical termination of pregnancy
Recovery after medical termination of pregnancy should include a number of activities. Abortion is a serious trauma, no matter how it is performed. After a medical abortion, pay special attention to yourself for 2-3 months. Don't lift heavy objects. Ask your family to help you clean. A gynecologist can prescribe you procedures and gynecological massage. Be sure to visit a physiotherapy room if your doctor advises you to do so. After an abortion, vegetative-vascular dystonia and nervous disorders may progress. Avoid stress and colds - medical termination of pregnancy weakens the body's defenses. Of the water procedures, only showers are allowed for the first month and a half. Prevent constipation. Change your underwear regularly. For the first month, exclude significant strength loads and sports. You can have sex after your first menstrual period after an abortion. Mifepristone is incompatible with alcohol consumption. We also recommend getting a mammogram.
Sex
Since 1999, every second woman has undergone medical termination of pregnancy. Alas, these are statistics. Few women live without abortions in their lives. Bloody discharge after this lasts another two weeks. During this time, you should, of course, abstain from sex. The risk of inflammation if this recommendation is not followed increases. The same applies to intimacy during menstruation.
Pregnancy
It is advisable to plan pregnancy after medical termination no earlier than 3 months later. Pregnancies that occur earlier are at high risk of complications. Medical termination of pregnancy in 95% does not affect the further possibility of conception; you can get pregnant in the next cycle, so take care of contraception. After a medical abortion, the immune system is often compromised, so if you do not restore the body, you may catch some kind of infection during pregnancy. Menstruation after medical termination of pregnancy Menstruation after medical termination of pregnancy normally returns immediately. A period delay of up to 20 days is considered normal. But for 70% of women they arrive on time. If you experience severe cramping pain during menstruation after a medical abortion, you should consult a doctor - this happens if not all of the embryo has come out.
In Kyiv, you can contact the URO-PRO medical center. Medical termination of pregnancy is done at 5-6 weeks. In 2 days another visit will be needed. During these days bleeding begins. After 16 days, a control ultrasound is performed.
You can also get a pharmabort by contacting the Kyiv clinic “Demetra” (Poznyaki district). It also provides colposcopy of the cervix and preventive examinations of women at affordable prices, treatment of STDs, menopause, and menstrual disorders. Remember that when the disease is latent, there are no pronounced symptoms, such as bleeding and pain in the lower abdomen. Regular examinations help to avoid serious diseases, incl. oncological A cancerous tumor never occurs on healthy tissue.
The center performs 300 types of tests. Here you can comfortably undergo rehabilitation after a medical abortion and receive psychological help if necessary.
The Atlanta Medical Center is also located on the left bank of the Dnieper in Kyiv. Here you can undergo medical termination of pregnancy in the early stages (6-7 weeks). The center also treats sexually transmitted infections, gynecological and sexually transmitted diseases, and provides gynecological and general massage.
At the Clinic Doroslikh on Lepse Boulevard in Kiev you can have a medical termination of pregnancy at an affordable price of 1200 UAH (ultrasound included). Here you will find understanding. The center's gynecologists know that a woman of any age is not 100% insured against unwanted pregnancy, even if she takes contraceptive measures. A medical abortion performed by an experienced gynecologist will not affect your health in any way. The procedure will take place according to all the rules prescribed in the pharmabortion protocol. For medical abortion, the clinic uses the drug Mifepristone, which has long proven itself to be reliable and effective. It is well tolerated by women. After the end of bleeding, you must undergo a control ultrasound again.
The Vemar medical center on the street has also proven itself well. N. Bazhana (Kyiv). Here they perform medical abortion in the early stages - up to 42 days from the 1st day of menstruation. Normal size of the uterus, absence of an embryo on ultrasound and no discomfort during a follow-up examination indicate a successful medical abortion. The clinic's doctors do everything possible to keep side effects to a minimum. The center’s gynecologists also treat colpitis, vaginitis and inflammation of the uterine appendages, polyps and endometriosis. The center's urologist provides assistance in the treatment of kidney and bladder diseases, as well as inflammatory prostate diseases and sexual disorders in men.
As you can see, the choice of medical clinics providing medical abortion is wide. The method of medical abortion is called by WHO to be the most gentle for women's health.
Medical abortion, otherwise pharmaceutical or “velvet” abortion, is a method of terminating pregnancy in its early stages using special drugs that does not require surgical intervention.
Advantages of medical abortion:
- Does not require surgical intervention;
- Produced in the early stages of pregnancy, when significant hormonal changes have not yet occurred;
- It is the least traumatic, since the cervix and mucous membrane of the uterus are not subjected to mechanical stress, due to which they remain intact;
- It does not have such severe consequences as others, and significantly reduces the risk of infertility in the future.
- There is no need for anesthesia, so this type of abortion is suitable for women for whom anesthesia is contraindicated;
- Menstrual function is restored within 28-30 days.
Description of the method
Pharmaceutical abortion is a single dose of a drug with the active ingredient mifepristone. Mifepristone blocks the action of the hormone progesterone, which stimulates the growth of the endometrium, resulting in the detachment of the embryo from the walls of the uterus. At the second stage, a drug is taken - an analogue of prostaglandins (the active substance is misoprostol), under the influence of which the muscles of the uterus begin to contract and the fertilized egg is pushed out of its cavity. Thus, a medical abortion is an induced miscarriage. According to statistics, its effectiveness is 95-98%.
Preparations:
Antigestagenic drugs(containing mifepristone 200 mg):
- Mifegin (France);
- Mifepristone (Russia);
- Pencrofton (Russia);
- Mifolian (China).
Prostaglandin preparations(containing misoprostol):
- Misoprostol (Russia);
- Mirolyut (Russia);
- Cytotech (UK).
These drugs are not sold in pharmacies without a prescription. The quality of the drugs used often depends on the country of origin (French tablets are considered the best). Medical abortion can only be performed under the supervision of a highly qualified physician in a medical facility. Before the procedure, it is recommended to find out what drug will be used and check the clinic’s license to permit this type of activity. Carrying out a medical abortion at home is unacceptable.
- From the very beginning of its development, humanity has tried to control birth rates and looked for ways to prevent unwanted pregnancies. you will find information about modern contraceptives.
- Emergency contraception methods are recommended only when it is necessary to prevent an unwanted pregnancy after unprotected intercourse or failure of other methods of birth control. These methods of contraception are described.
- Today, intrauterine contraception is very popular among women. Statistics show that more than seventy percent of women successfully use contraceptives.
Medical abortion can only be done in the early stages - up to 42 days from the first day of the last menstrual period (or up to 49 days after the end of the last menstrual period). Abortion is most effective up to four weeks, while the fertilized egg is still weakly attached to the wall of the uterus and hormonal changes in the body are insignificant. In the future, the effectiveness of the procedure is greatly reduced and the risk of possible complications increases sharply.
Stages of medical abortion
Preliminary inspection
A gynecologist diagnoses pregnancy and sets its exact date. It is necessary to exclude ectopic pregnancy (in case of which medical abortion is unacceptable) and the presence of contraindications.
First stage
The patient takes mifepristone 600 mg (3 tablets) in the presence of a doctor and remains under his supervision for 2 hours. She then receives recommendations and medications for the second stage of abortion. At the first stage, cramps in the lower abdomen may occur and spotting may appear, which is normal. It is better to do a medical abortion no earlier than 2 hours after the last meal.
Second phase
36-48 hours after taking mifepristone, the patient should independently take the prostaglandin preparation given by the doctor. It is advisable to stay at home throughout the day. The degree of pain and the amount of bleeding depend on individual characteristics. It is important to follow all doctor's recommendations and take only approved pain medications as needed.
Control examinations
3 days after taking mifepristone, the patient should undergo a gynecological examination and the first control ultrasound, and after 7-14 days a repeat examination and ultrasound control. If necessary, an hCG test is taken to confirm the abortion. In case of incomplete abortion, vacuum aspiration or curettage is performed.
Contraindications for medical abortion
- Ectopic pregnancy;
- Inflammatory gynecological diseases;
- Uterine fibroids;
- Inflammatory diseases of the gastrointestinal tract;
- Acute or chronic renal or liver failure;
- Pregnancy resulting from the use of;
- Anemia and bleeding disorders;
- Individual intolerance to mifepristone;
- Taking corticosteroid drugs and anticoagulants.
Restrictions:
- Smoking over 35 years of age;
- Postoperative scars on the uterus;
- Hypertension;
- Lactation (you must stop breastfeeding for 14 days).
Possible complications after an abortion
Even if all instructions are followed, an unfavorable outcome from a medical abortion cannot be ruled out.
- Continuation of pregnancy or incomplete abortion;
- Uterine bleeding requiring medical intervention;
- Abdominal pain;
- Nausea, vomiting;
- Weakness, dizziness;
- High blood pressure, migraine;
- Increased body temperature;
- Allergic reactions (rare).
You should abstain from sex for two to three weeks so as not to provoke bleeding and the development of inflammatory processes. One of the consequences of an abortion may be a change in ovulation, and, as a result, a woman runs the risk of becoming pregnant 11-12 days after the procedure. Therefore, immediately after an abortion you need to start using contraception. If the outcome is successful, you can plan a pregnancy after 3 months.
There are no significant delays after this procedure. In most cases, the first menstruation after an abortion begins after the number of days that constitutes the normal cycle for a given woman, if the first day of the previous menstruation is considered to be the day of the abortion or the time of the onset of bleeding that occurs within 24 hours after taking the drug. The rapid restoration of the cycle is explained by the absence of mechanical damage to the uterus and hormonal disruptions.
For several months after an abortion, deviations in the direction of increasing the duration of the menstrual cycle are allowed; the delay can be up to 10 days.
Natalia:
I am 31 years old, I have two children, I had a medical termination of pregnancy for medical reasons at 6 weeks. I want to say the main thing: everyone has a different body and different tolerance. Everything went fine for me, I'm happy with the result. The doctor warned against taking aspirin and thermal treatments (sauna, hot bath, etc.), as this could cause severe bleeding. I strongly advise everyone to stay at home while taking the pills, preferably under the supervision of relatives, as severe dizziness occurs, almost to the point of loss of consciousness.
Arina:
I am 24 years old. I'll get straight to the point. Ultrasound showed a period of 3-4 weeks. After taking the first three tablets, I felt slightly nauseous and had general weakness. After the remaining pills, it was pouring out of me so much that due to the enormous loss of blood, I was moving along the wall from the sofa to the toilet. At the same time, clots the size of a small chicken (!!!) egg came out. This lasted from 5 to 9 pm. The vegetable’s condition lasted for about five days; I constantly wanted to lie down and felt dizzy. The discharge continued for about 2 weeks. After this nightmare, I want to say - between vacuum aspiration and medical abortion, choose a vacuum, I did that too. So, in this case, you came to the clinic, suffered for 3 minutes and went home, you don’t have to walk around like a vegetable for a week, not knowing whether everything went well or whether they’ll send you for cleaning.
Anna:
I had a pharmaceutical abortion twice, for up to 6 weeks, using Russian drugs in a private clinic. Everything was fine, no heavy bleeding, no severe pain. The doctor said that such an abortion cannot always be performed on nulliparous women. I wish everyone to take better precautions, it’s still a little difficult mentally.
Until recently time It was believed that pregnancy could only be terminated through surgery. However, today there are many other methods, among which medical abortion has become somewhat popular. Some women believe that taking the pill will get rid of an unwanted pregnancy. This is true, but do not forget about the possible complications that can result from taking just one pill.
Abortion- this in itself is a risky business, because it is unknown how the body will react to such an unceremonious intervention in the vulnerable structure of the female reproductive system. Someone can undergo 5 abortions and still retain the ability to conceive and bear a healthy child, while another woman will become infertile after the first abortion. The surgical method of terminating a pregnancy has been around for many years; we can say that the procedure for performing such an abortion has been worked out for years. The same cannot be said about medical abortion, because indeed the results often exceed expectations, and not in a good way. No matter how the benefits and safety of medical abortions are described, the percentage of complications after it remains quite high, in particular, many women, after provoking a miscarriage, cannot subsequently have children for various reasons. And if during the process of surgical termination of pregnancy the doctor can control the situation to one degree or another, using various tools, observing what is happening, using medications if necessary, then with a medical abortion the doctor does not have this opportunity. To some extent, taking the pill is a possibility: either everything will go well, or there will be complications that you will have to deal with later.
How it is done medical abortion? It happens in 2 stages. First, the woman takes the first pill, which causes fetal death. This pill causes growth to stop, and the myometrium begins to actively contract, which leads to separation of the fetus from the uterine wall. After 36 - 48 hours, when the fetus has died, the woman takes a second tablet. It stimulates the contractile activity of the uterus, and the dead fetus is expelled.
What are the most common complications of medical abortion? One of the serious consequences of taking the pill is incomplete miscarriage. This means that part of the fetus and its membranes may remain inside the uterus. The longer the pregnancy, the higher the likelihood of such a complication occurring during a medical abortion. Then a real chain reaction can develop, which ultimately leads to irreversible changes. The remaining part of the fetus provokes the development of an infectious process in the uterus.
Infectious process affects the mucous membrane, and sometimes the muscular layer. Do not forget that in the uterus for some time there is a wound from the place of attachment of the fetus. If it becomes infected, sepsis may develop. Unfortunately, the mortality rate from sepsis is simply enormous; in this case, a woman’s chances of survival are reduced to a minimum. In this regard, medical abortion is contraindicated for women who have inflammatory diseases of the uterus or ovaries. In all cases, a medical abortion should be performed only in the presence of a doctor who will monitor the woman’s condition and, if necessary, provide first aid.
Rejected the fetus is carefully examined, all parts and surrounding tissues of the embryo are compared, nothing should remain in the uterus. Then a control ultrasound examination is performed. If any piece is missing, you have to perform surgery - scrape out the uterus or use vacuum aspiration. In addition, with a medical abortion, the risk of bleeding remains, so this method of termination of pregnancy is contraindicated in women with reduced blood clotting. Medical abortion may be accompanied by nausea, vomiting, severe abdominal pain and increased blood pressure.
The technique of performing a traditional abortion is shown in the section for medical professionals -
However, having listed everything risks complications of medical abortion, it should be noted that this option of termination of pregnancy still remains promising in some respects, but requires serious improvements in order to reduce the number of complications. Its effectiveness is quite high, but medical termination of pregnancy can be carried out only in the early stages of 6-7 weeks, when serious changes in the woman’s body have not yet occurred. The earlier the deadline, the higher the effectiveness of this method. It must be admitted that physically it is the least traumatic for the uterine mucosa, because it is not scraped out, especially since the embryo at such stages of pregnancy is not yet firmly held in the wall of the uterus. However, just one tablet contains a truly killer dose of hormones. Because of this, a woman’s hormonal levels can change for a long time. Even restoring a normal menstrual cycle for some women after a medical abortion can be very difficult.
To summarize, we note several main principles, which will help reduce the risk of complications after medical abortion.
1. Both tablets must be taken in the presence of a doctor. After the pregnancy is terminated, the woman must undergo and remain under observation for some time.
2. Before a medical abortion, you must undergo an examination by a gynecologist in order to exclude the presence of infectious diseases.
3. Medical termination of pregnancy can be carried out no later than 48 days after a missed period, that is, at 6-7 weeks of pregnancy, but no more than this period.
4. Some time after a medical abortion (about a week), the woman should visit the gynecologist again, possibly taking the necessary tests to exclude the possibility of developing late complications.
Educational video of indications and contraindications for termination of pregnancy (abortion)
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There are several methods to terminate an early pregnancy. Each of them has its own risks and contraindications. In the article we will look at medical abortion, how the procedure works, and whether there are any risks.
Until recently, vacuum or mini-abortion was the only way to terminate an early pregnancy. But it had many side effects due to the fact that it involved intervention in the uterine cavity, which can lead to injury or infection.
That is why scientists have studied alternative methods of terminating pregnancy that do not require instrumental intervention. After the invention of hormonal drugs such as Mifepristone and Misoprostol in the 80s, medical termination of pregnancy became possible. Let's look at how everything happens next.
Drugs for medical abortion
Today there are many analogues of Mifepristone - Mifeprex, Miropriston, Mifegin, Pencrofton, RU-480 and others. These are progesterone antagonists, which, in addition to abortion, in a certain dosage can be used as emergency contraception (Gynepristone). The effect of these drugs is to block the action of progesterone, the main hormone responsible for the development of pregnancy. In parallel with the above drugs, Cytotec is used to terminate pregnancy. How to take medications depends on the situation. Therefore, the gynecologist should prescribe the dosage.
Misoprostol has also acquired different trade names and is also known in Russia as Mirolut. Prostaglandins contained in the drug provoke contractions of the muscles of the uterine walls, after which the fertilized egg is expelled from the cavity.
At what period and how is medical termination of pregnancy done?
The decision to have a medical abortion is made by the woman. The pregnancy period should not exceed 49 days from the beginning of the last menstruation. Existing contraindications should also be taken into account, including:
- suspicion of the development of an ectopic pregnancy;
- renal or liver failure in acute or chronic form;
- long-term use of certain hormonal drugs (dexamethosone, prednisolone, etc.);
- taking anticoagulants;
- exacerbation of inflammatory processes in the woman’s urogenital system;
- presence of uterine fibroids;
- pregnancy occurring when using an intrauterine device or immediately after discontinuation of oral contraceptives;
- severe form of bronchial asthma;
- individual intolerance to drug components.
During the first visit to the gynecologist, a woman undergoes a gynecological examination and undergoes the necessary tests, including smears and blood tests. Ultrasound diagnostics of the pelvic organs is also necessary to eliminate the risk of ectopic pregnancy. Before terminating a pregnancy using medication, the doctor will consult you about the possible risks. The woman signs consent to use a particular drug for this purpose.
How does pregnancy termination occur with the help of medications? This will require three steps. On the first day, after a light breakfast, a woman drinks 3 tablets of Miropriston or analogues with a dosage of 200 mg, remaining under the supervision of a doctor for several hours. After this time, the patient is sent home, but at the first fear that something is going wrong, she should call the doctor.
The second visit is 48 hours after the first dose. On this day, take 2 tablets of Mirolut or analogues with a dosage of 200 mcg. Within a few hours, bleeding from the vagina should begin. If they are not observed, the Mirolyut administration is repeated. As a rule, the amount of discharge, as well as the duration, varies depending on the duration of pregnancy and the individual characteristics of the woman’s body. Usually spotting is present for 1-3 weeks. Sometimes it may be necessary to take hemostatic drugs.
The third visit to the gynecologist is scheduled no later than two weeks after the second. The doctor conducts a follow-up examination and ultrasound to exclude the possibility of complications such as incomplete abortion or a pregnancy that continues to develop. The doctor is developing a method for preventing unwanted pregnancy in the future.