What kinds of abortion: types of abortion in the early and late stages

The optimal method of abortion is determined by the physician in consultation with the pregnant woman. Gynecologist should explain to the patient what are abortion, and to recommend one of the species, taking into account the gestational age and state of health.

Types of abortion and its timing

The method of disposal of unwanted pregnancy is dependent on such factors:

• a woman's desire to get rid of the fetus in a certain way;
• health facilities;
• gestational age;
• the state of health of the patient.

If the woman decided to have an abortion in the first weeks, she can offer these types of miscarriage in early pregnancy:

• medical termination;
• mini-abortion (vacuum aspiration);
• dilation and curettage (scraping).

If the period exceeds 11 weeks and 6 days, to terminate a pregnancy is possible only if the social or medical indications. To interrupt may recommend surgical or conservative methods.

To surgical methods to get rid of the fetus include:

• dilation and evacuation;
• small caesarean section.

More preferred are considered conservative therapies. The woman introduced special substances that trigger the onset of labor.

medical abortion

If we turn to the gynecologist before 6 weeks of pregnancy, it can terminate its offer with the help of pills. It is the most gentle of all types of abortions, but it is carried out only at an early stage. In Russia advised to take the tablets, provoking an abortion before 42 days, counting from the first day of the last menstrual period. Pregnancy should not be more than 6 weeks.

Comment! Some gynecologists recommend doing a medical abortion up to the end of 8 weeks of pregnancy, which corresponds to 62 days of absence of menstruation.

If you can not get rid of the fetus other way, under the supervision of physicians can do medical abortion, and at a later date. It is only necessary to consider the following: the longer the duration of pregnancy, the greater the likelihood of complications.

Medical abortion is performed on an outpatient basis, as this is the safest form of abortion. Make it in 2 stages. Initially, the woman should drink 600 mg of mifepristone (mifepristone formulations, Mifegin), and after 36-48 hours - 400 mg misoprostol (misoprostol, Mirolyut).

First means operates as follows:

• blocks progesterone production process;
• It increases the sensitivity of muscle fibers of the uterus to oxytocin;
• softens the cervix.

Under the influence of mifepristone in the womb creates a hostile environment, and the fetus dies. Misoprostol triggers the expulsion process of the ovum. The uterus begins to contract as in childbirth. In 90% of patients within 6 hours miscarriage occurs. For some, this process takes up to 1 week.

After taking pills for abortion should remain under medical supervision for 2 hours. In the event of complications in the hospital can be to get extra help.

Surgical methods of abortion

If the woman has addressed in gynecology at the period when medical abortion is not recommended to do, or it has contraindications to tablets, it is possible to terminate a pregnancy surgically. Such methods of abortion are also used if the patient does not want to take pills.

vacuum aspiration

Most gentle surgical technique is considered to interrupt vacuum aspiration. It is made before 7 weeks of pregnancy.

Make vacuum abortion is the state or a private clinic. It is held on such a scheme:

• woman is in a gynecological chair;
• vulva doctor treats an antiseptic solution;
• vagina gynecologist inserts a speculum;
• Doctor extends through the cervix and the cervical canal into the uterine cavity enters the cannula, which is connected to a vacuum aspirator;
• gynecologist includes device, it creates a negative pressure in the uterus, because of this ovum comes off from the walls;
• after the procedure, the doctor removes the cannula from the cervix and vagina of a mirror.

The procedure is performed under local anesthesia. its time is typically less than 10 minutes. According to WHO recommendations among all surgical methods of abortion is better to choose a vacuum aspiration.

Important! Some clinics spend vacuum interrupt patients before 9 weeks of pregnancy. If the procedure will be performed by a qualified surgeon-gynecologist, the probability of a successful abortion, even in a longer shelf will be above 95%.

Dilation and curettage

Standard surgical curettage is considered one of the most dangerous types of abortions in gynecology. It is conducted for a period of 6 to 12 weeks. But in the CIS - this is one of the most popular types of abortion, making it much more often than with other methods.

It is carried out under anesthesia in the following way:

• woman is in a gynecological chair;
• the doctor treats the vulva with antiseptic and inserted into the vagina speculum, captures and processes the neck;
• cervical canal diameter increases gynecologist via expanders Gegara - this procedure is called dilation;
• after reaching the desired diameter dilators doctor withdraws and enters the uterus curette (surgical instrument configured in the form of bent rods with the loop) and all scrapes endomery stripes;
• scraped fertilized egg is retrieved out, but this procedure is not terminated, the doctor must remove the entire endometrium in the uterus that do not remain part of the ovum.

Once completed, the gynecologist removes a mirror from the vagina, and the patient was sent to the House. In most cases, women do a short-term intravenous anesthesia. The procedure takes less than 20 minutes. If a woman complains of feeling unwell, it can be on the same day to go home.

Many doctors refuse to do scraping after 11 weeks of pregnancy. The longer, the higher the probability of postoperative complications.

Dilation and evacuation

If there are medical and social pregnant for a period of 12 to 16 weeks may make surgical termination. A type of late-term abortions is dilation and evacuation.

Termination of pregnancy by this method can be carried out after pre-treatment, which takes 2-3 days. The procedure consists in the fact that the patient initially expanding the cervical canal to the desired diameter. This can be done by using special sticks kelp or drugs for cervical softening.

After expanding the cervical canal operating gynecologist proceeds to the second phase the abortion - evacuation of the fetus and the membranes. This can be done with a vacuum aspirator, aborttsanga and curettes. Aborttsang - surgical instrument that resembles a forceps. They capture the ovum or the fruit and extract them to the outside. After that, the gynecologist curette scrape the inner surface of the uterus, the endometrium, and to remove the remnants of the placenta.

Comment! The recommended period of dilation and evacuation is between 12 and 16 weeks, but surgeons have resorted to this method of interrupting up before 22 weeks of pregnancy.

The likelihood of complications after this procedure is high. Abortion may be accompanied by profuse bleeding, it decreases when the uterus begins to contract.

artificial birth

One type of abortion in late pregnancy is the stimulation of labor. This method is preferred compared to dilation and evacuation due to the fact that using drugs interrupt procedure is as close to natural childbirth.

For this purpose, first prepare the cervix so that it is relaxed and the cervical canal is widened. After that stimulate uterine contractions.

To prepare in the cervical canal gynecologist can insert laminaria sticks. They gradually increase in size in a wet environment and provoke a mild cervical ripening. This method allows for increasing the diameter of the lumen it 3-5 times for 4-12 hours. If the cervical canal is widened enough, then after 12 hours, you can enter tampons kelp again. They are inserted into the channel in such a quantity that fits.

To accelerate the process of preparation is possible by simultaneous use of drugs containing prostaglandins and kelp. For the structural changes in cervical connective tissues using Tserviprost Prepidil or gel. Under the influence of their neck smoothed out, and its channel is opened.

After cervical ripening can begin to induction of labor. For these purposes prostaglandins - substances that trigger uterine contractions. In many hospitals use Prostin 15 M, which is administered intramuscularly every 2 h. As soon will be able to achieve the appearance of regular uterine contractions, do amniotomy. This further accelerates the generic activities.

In many clinics the practice of using products containing mifepristone and misoprostol for late-term abortions. If a patient 22 weeks pregnant or more, parallel prescribed potassium chloride injection to kill the fetus. Under the influence of this drug in the child's heart stops or stops blood flow through the umbilical cord.

When the term of more than 16 weeks may recommend a saline abortion. For its part of the amniotic fluid is replaced hypertonic saline or urea. Under its influence the fetus dies. After the introduction of labor-inducing activity, and the woman gives birth to a stillborn child. But this method is now little used.

What abortion is safer

Select the most preferred method of abortion necessary together with a gynecologist. It is best not to delay the decision, because at 3-4 week list of safe methods of abortion is more extensive.

If the period is less than 6 weeks, you can make medical abortion. Despite the fact that this type of medical abortion is considered one of the safest, the patient after the meeting, complications may occur. Most often, there are hormonal imbalance, psychological problems. In rare cases, incomplete abortion or possible discovery of uterine bleeding.

Comment! The likelihood that a woman will require surgical assistance during the abortion tablet for up to 6-7 weeks, does not exceed 0.2%.

If there are contraindications to the tablets or woman does not want to drink, the doctor may advise vacuum aspiration. For security, this method is on the 2nd place. When using it excludes complications such as uterine perforation or cervical rupture. In addition, minimizing the chance of bleeding and infection.

Scraping method is considered the most dangerous traps. WHO recommends to resort to it in very rare cases. When using this method of abortion there is a high risk of complications. They can be both instant and stitched.

Among the most common are called:

• cervical injury;
• bleeding;
• development of infectious diseases;
• hormonal disorders;
• endometriosis;
• inflammatory diseases;
• adhesive disease.

The most dangerous complication of perforation of the uterine wall is considered. This is a situation in which the surgeon pierces the curette the uterus, it can also damage the intestine. It is important to have an immediate surgical care. Depending on the degree of damage to the operating gynecologist can take in the uterus or remove it completely.

Any type of abortion in late pregnancy is potentially dangerous. If possible, it is best medication to stimulate uterine contractions so that abortion was as close to the holding of a natural birth.

conclusion

Before issuing a direction to the interruption of a gynecologist should explain to the woman what are the abortion, how they differ, and talk about the likelihood of complications after each of them. When you call in early pregnancy is recommended medical abortion or vacuum aspiration. Otherwise you will have to do a surgical abortion.