Interruption of pregnancy in the early stages

, medical expert
Last reviewed: 24.06.2018

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Termination of early pregnancy is a concept that includes interrupting pregnancy at the request of a woman before the twelfth week, and also for medical reasons until the twenty-second week. There are many tools and methods, but it is necessary to know the indications for the application of each of them and the peculiarities of using these methods.

trusted-source[1], [2], [3], [4]

Features of abortion in different situations

Speaking of abortion, one should not mean at once something terrible, both in technology and in prejudices about the process itself. Each case of pregnancy is individual and the issue of saving a child's life is decided by his parents. Therefore, the main goal is to choose the most suitable method, which will ensure a minimum number of complications in the future.

Interruption of pregnancy for up to twelve weeks can be performed by any woman at her request. Indications for such a procedure may be, in addition to the desire of a woman - a pathology from the fetus, which is detected at such an early date. If it is not possible to identify any congenital pathology of the fetus for up to twelve weeks, and it is confirmed at a later date, then the woman is offered to carry out the termination of pregnancy up to the twenty-second week. Thus, the indication for abortion in the early stages is the woman's desire, but before the twelfth week, or an abortion for medical reasons, which can be performed before the twenty-second week. Abortion in a later period is considered a crime, since a fetus is formed and after this time it is considered fully viable. Speaking about medical indications for abortion, most often the cause is a child's genetic pathology. As a rule, at such a time, Down's syndrome is well diagnosed. In this case, according to the results of the first ultrasound, this pathology can be assumed, and then, until the twenty-second week, invasive diagnostic methods are performed-amniotomy and amniopuncture. This allows you to confirm the diagnosis and offer a woman an abortion at an early age, and the decision is made by the woman herself. Also, any other genetic pathology - Edwards syndrome, Patau, trisomy on sex chromosomes, congenital malformations of the skull, heart, and much more - can also be an indication. But in any case, even though this is an indication, parents make a decision, having assessed all the risks and consequences.

Contraindications to termination of pregnancy in the early stages are limited to those of the mother and child. One of the contraindications is inflammatory diseases of internal genital organs in the acute stage, which in the early postoperative period can give serious inflammatory complications and even a septic condition. Also, contra-indications on the part of the mother are blood diseases, which are accompanied by its low coagulability of hemophilia B, idiopathic thrombocytopenic purpura. As for other diseases, this is an acute course or period of exacerbation of systemic diseases of connective tissue. In the period of acute inflammatory diseases of the lungs, kidneys - it is also impossible to carry out any invasive surgical interventions.

Contraindications from the fetus are limited to the duration of the procedure, that is, at a later date, termination of pregnancy is not carried out.

With regard to the legal side of this issue, abortion should be carried out by agreement with the mother and father of the child, and if the father of the child is against this, then it can be considered a contraindication.

Preparation for early termination of pregnancy consists in general actions that must be performed in any way and in separate cases separate preparation is necessary, which depends on the method of abortion. And the methods can be different, depending on the period and conditions of the conduct.

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Basic methods of early termination of pregnancy

Methods that are used to interrupt pregnancy in the early stages can be divided into medical and surgical ones, and the latter in turn can be small surgical interventions and surgical operations.

Medication abortion at an early stage is the use of drugs with a different mechanism of action to initiate an induced abortion. Different drugs act differently. This depends on the conditions of admission, the length of pregnancy, at which they can be carried out, as well as basic warnings for use. Tablets for early termination of pregnancy are mainly directed to systemic influence, and pharmacological form of candles can also be used.

  • Postinor is a common drug that is used in unprotected intercourse. It is necessary to take into account certain features of the action for the best effect. This drug is a derivative of progestogen. After taking the drug, due to its progestational effect, it promotes inhibition of the ovulation process, reduces the activity of endometrial glands and worsens the conditions for normal implantation of the oocyte. This postponement of the process of ovulation prevents the development of pregnancy, since the sperm is already dying before the release of the oocyte. If fertilization has already occurred, then the drug does not have any effect and in that case does not have any effect. Therefore, the main condition for such an emergency method of avoiding pregnancy is the use of tablets in the pre-initial period and taking in the next three days after unprotected sex.

The effectiveness of this drug in the case of admission in the first twenty-four hours after intercourse is more than 90%, and after seventy two hours - about 50%. Therefore, for a more accurate effect you need to take the pill in the first day. The drug is produced in the form of pharmacological tablets of 75 milligrams, two pieces in a package. Admission medication should be started immediately after unprotected sexual relations - you need to take one pill orally, not more than twelve hours after the first - and the second dose of the medicine. Side effects are possible in the form of nausea, dyspepsia, decreased appetite, vomiting. If there were diarrheal disorders during this method of contraception, then you need to take the same dose for effectiveness. Allergic manifestations are also possible. Possible action of the drug on the subsequent menstrual cycle, in which case there may be a delay in menstruation, but not more than a week, and also spotting from the vagina.

Contraindications to taking the drug - it's age until 16 years, taking during pregnancy, and also you can not use Postinor as a permanent contraceptive.

Thus, Postinor is not so much a means for aborting pregnancy, as a means for emergency prevention of pregnancy.

  • Oxytocin is a natural hormone that is excreted by the female body. This is not a means for aborting a pregnancy, but rather for monitoring the condition of a pregnant woman.

Under normal conditions, oxytocin is secreted by the hypothalamus during the entire pregnancy, but before its delivery, its concentration is the highest. This ensures normal labor activity, because oxytocin stimulates uterine contraction. Therefore, oxytocin can be used to interrupt pregnancy, but under special conditions. It can be used at a later date, after twelve weeks, but only after the opening of the cervix. Thus, this remedy can only be used for medical abortion and only in a medical institution. At the same time, the uterus contraction is stimulated and abortion passes as a natural birth process. This method of abortion is not the most effective, in such cases it is necessary to give preference to operational methods.

Oxytocin is used in parenteral form, it is most often used intramuscularly in a dose of ten units of action. Do not use the drug in the presence of scars on the uterus.

  • Progesterone is a natural human hormone that is excreted by the woman's ovaries and provides a normal course of pregnancy.

It helps to prevent ovulation in the presence of pregnancy, and also improves the trophism of the endometrium, which increases the efficiency of implantation of a fertilized egg. Therefore, for the termination of pregnancy, analogues of this hormone are not used, but its antagonists use it. Progesterone can be used as a contraceptive as part of complex contraceptives.

Duphaston is a drug containing the natural hormone progesterone. It is used in the event of a threat of termination of pregnancy, so the opinion about its effectiveness for early termination of pregnancy is erroneous.

  • Aspirin is a non-steroidal anti-inflammatory drug that affects the fetus, especially in the early stages. This drug has many side effects on the hematopoietic system, as well as on the fetus. Aspirin causes contraction of the uterus and as a result, there may be premature labor, that is, miscarriage. Therefore, taking this medication in the first trimester of pregnancy is not recommended. But do not use aspirin for abortion, especially at home.

This is due to the fact that there is no dosage that would cause the effect of abortion and for each woman it can be its own, and excessive uterine contraction can cause serious bleeding. Therefore, aspirin is not a means of interrupting pregnancy in the early stages, because there are more reliable and safe medications.

  • Sinestrol is a hormonal agent that has an effect similar to estrogens because of its analogous action with folliculin. The mechanism of action of the drug is to increase the concentration of estrogens and their effect on the endometrium. Under normal conditions, during pregnancy, the level of progesterone rises, and the level of estrogen decreases, which ensures the normal functioning of the uterus and the placenta.

In the case of an increase in the level of estrogens or with a relative deficiency of progesterone, the activation of muscle fibers occurs and the uterus begins to contract. In this case, the use of Sinestrol leads to a reduction in the uterus and the beginning of miscarriage, that is, termination of pregnancy. This method of treatment should be carried out under strict medical supervision, since it may start bleeding. The drug is available in tablets, but for the interruption of pregnancy use more injectable forms. In this case, the route of administration of the drug intramuscularly according to the scheme, but not exceeding the total dose - no more than 3 grams. It is necessary to monitor the condition of a woman. Side effects are possible in the form of dyspeptic phenomena - nausea, abdominal pain, vomiting, and bleeding from the genitals and changes in the mammary glands.

  • Wife is a preparation of mifepristone, an antagonist of progesterone receptors. This drug in combination with misoprostol is used for medical abortion most often.

The mechanism of action of the drug is a blockade of receptors in the uterus to progesterone and in large dosages the drug stimulates the contraction of the myometrium and the egg leaves the uterine cavity. Also, the drug increases the sensitivity of receptors to prostaglandins, which increases the rejection of the decidua. Therefore, it is necessary to use the drug in combination with prostaglandins. The use of the drug as a means to interrupt pregnancy in the early stages is possible only up to 49 days of pregnancy, the best option is the fourth-fifth week of pregnancy. The drug is available in the form of tablets of 200 milligrams three or six pieces per package. The drug is taken at a medical facility in a dose of 600 milligrams, that is, three tablets at a time, after a light breakfast. Then we need to observe an hour or two for the appearance of side effects. Perhaps nausea, vomiting, pain in the abdomen, discharge from the uterus. Then the patient leaves home and comes the next day to continue - the second stage.

  • Misoprostol is an analogue of prostaglandin E, which is the second stage of abortion. The drug stimulates the reduction of the uterus in high doses and after the rejection of the decidua due to the use of mifepristone, the drug promotes the release of the remains of the fetal egg.

The drug is taken 24 hours after the first phase in a dose of 400 micrograms, that is, two tablets. Then there begins spotting by the type of menstruation, if the gestation period is 4-5 weeks. Such discharges last from three days to three weeks as much as possible. It is necessary to monitor the condition, since anemia and other side effects in the form of uterine bleeding are possible. Thus, abortion occurs in the case of the use of medications - Mifepristone or Genital in combination with misoprostol.

Such means of abortion in the early stages with the help of drugs are also effective, but they should be used precisely under the above conditions, and also under the supervision of a doctor, then their effectiveness is high, and the threat of complications is the least. In any case, one should not forget about the possible complications of such medical abortion, because there may be incomplete abortions or the remains of the fruit shells, so it is necessary to have an examination with a doctor after this kind of abortion, better ultrasound control. Before deciding on such methods of abortion it is necessary to evaluate all the conditions of pregnancy, its duration, the presence of contraindications, and then choose the optimal method.

trusted-source[10], [11], [12], [13]

Interruption of pregnancy in the early stages of alternative means

Speaking about alternative methods of abortion, it is necessary to note first of all that all means are not completely safe and it is not recommended to conduct them without further consultation of the doctor. It should be borne in mind that alternative methods have a very high risk of complications and the possibility of incomplete abortion or bleeding is very high. To date, there are many professional operational and minimally invasive medical methods that need to be given preference over alternative methods. But you also need to know some herbs and alternative ways that you can use for this purpose. Such methods are often recommended to combine with physical exercises for a more complete effect and to enhance uterine contraction. Exercises for early termination of pregnancy are mainly those that increase intra-abdominal pressure. This is the swing of the press, squatting, bringing the legs to the stomach, as well as intense jumps.

Herbs for interrupting pregnancy in the early stages have a similar mechanism of action with drugs that stimulate premature contraction of the uterus and thus there is an artificial miscarriage.

  • Tansy is a multi-colored medicinal plant that is used in medicine in its various directions. This plant has a stimulating effect on the secretion of cells, and also has an antihelminthic property. Use for medicinal purposes as the flowers of this plant, and pour, the roots. The mechanism of action that causes the termination of pregnancy is the stimulation of uterine contraction due to the content of biologically active substances that are similar in composition to prostaglandins. Also tansy contains many alkaloids and phytophavonoids, so the use of this plant should be clearly metered.

The intake of this herb is effective in the fourth-fifth week of pregnancy, so to achieve the effect you need to start taking the medicinal infusion from the first day of the delay in menstruation. The solution should be prepared as follows: ten grams of dried tansy flowers (these are two teaspoons) should be poured hot water in the amount of 250 grams, then this solution must be insisted and drunk throughout the day before meals three times a day for fifty grams, that is, a pile . After the onset of cramping pains in the lower abdomen, stop taking. The effect of the drug can also appear without pain in the lower abdomen, then there will be spotting by the type of menstruation - this is the beginning of an artificial abortion. There may be side effects during the administration of the drug - blood pressure rises, palpitations occur, nausea and vomiting can occur, and uterine bleeding can also begin, so you need to carefully monitor your condition.

  • The Bay Leaf for abortion is also a remedy that can be used at home. This plant, which grows in warm climatic conditions and is widely used in everyday life as spices. This plant has application in medicine due to the contents of resins, tannins and phytoncides. Phytoncides have a neutralizing effect on the mycobacterium tuberculosis, which often allows this plant to be used in medicine for this purpose. Such substances contribute to stimulation of the secretion of the gastrointestinal tract and enhance intestinal motility. This effect is also expressed in relation to muscle fibers of the myometrium.

In this case, laurel stimulates not only the reduction of the uterus, but also increases its tone, and this is the property and take as the basis for using laurel for abortion in the early stages. For the preparation of vegetable infusion to stimulate uterine contraction, it is necessary to take four to five medium bay leaves, pour a glass of hot water and insist half an hour. Such a solution should be drunk on an empty stomach, and then repeated at lunch, if there is no reaction. After such an infusion is recommended to improve the contractility to exercise or take a warm, but not too hot bath. After such procedures, a uterine contraction is possible, which will manifest as spasmodic pain in the abdomen and bloody discharge from the uterus.

  • Parsley is an annual green plant that is eaten because of its rich composition on essential oils, phytoncides, vitamins. It contains a lot of vitamin C, which strengthens the wall of blood vessels. This is a very useful product for pregnant women, but when used in moderation, as a condiment to salads. Parsley can act as a means for terminating pregnancy in two ways. The first option is the oldest - it is believed that the root of parsley stimulates uterine contraction. To do this, you need to wash the root of parsley and shove it into the vagina - this helps to open the uterine throat and stimulation of contraction begins. But this method is not recommended because of its trauma and low efficiency.

The best means is infusion of parsley, which dilates the vessels of the uterus and strengthens the local circulation - it stimulates the uterus and it begins to contract - so begin premature uterine bleeding. To prepare this infusion, you need to cut five sprigs of parsley green and pour 200 milliliters of water, then insist and take half a glass twice. The effect can appear immediately or after a few hours.

  • Oregano is a perennial plant that has a pronounced effect on the bronchial tree, by enhancing the work of the glands and expectorant action. In addition to these properties due to the content of essential oils and tannins, this herb is used to induce artificial abortion.

The effect of this infusion is a bidirectional state. At the same time, oregano causes the uterus to contract and increase its tone, and at the same time it increases the level of estrogen to such a concentration that it can cause rejection of the fetal egg. These effects also underlie the use of oregano for the interruption of pregnancy in the early stages. The infusion of oregano is prepared in a standard way - while the grass needs to be poured with boiling water, insist and take half a cup three times a day.

  • Sage - a flowering plant that has in its composition a lot of vegetable oils with a strong aroma and irritating effect, as well as coumarins - substances that reduce blood clotting.
  • The action of sage is expressed by the intensification of the irritating effect on the central nervous system of the fetus and this disrupts the trophic and the transmission of nervous excitation. This increases the negative interaction and trophicity of the placenta, which causes rejection of the fetus in the early stages, as a protective mechanism. For a better effect, it is recommended to perform uterine massage through the anterior abdominal wall - this increases the contraction and release of the abortive material.

Talking about the termination of pregnancy by alternative methods using herbs, it is necessary that a woman understand that if pregnancy is undesirable, then in our country there are many methods of abortion with the help of qualified medical care and it is not worth using such dangerous methods. It is difficult to control the contraction of the uterus, if the dose of this or that infusion from the herb is not determined accurately - it can cause severe bleeding and other complications. Therefore, although there are many alternative methods, but do not put them in the first place, because even if this pregnancy is undesirable, then another pregnancy may be necessary. Therefore, be attentive to your health.

See also: Herbs for abortion

Surgical interruption of pregnancy in the early stages

Surgical methods of abortion are used when the term of pregnancy excludes the use of medical abortion. All operative methods can be minimally invasive - this is a vacuum-aspiration of the fetus, as well as more extensive surgical interventions. Therefore, the main indication for surgical methods of abortion is later dates - after the fifth week, when medical abortion is not performed. The main contraindications to the rapid termination of pregnancy are first of all an ectopic pregnancy. In this case, you will not be able to eliminate such a pregnancy, but you can only cause severe bleeding. The presence of a cervical cyst or endometrial cyst of the uterus is also a contraindication to this procedure. There may be a traumatic cyst rupture, which will promote the development of bleeding or complications after surgery.

Preparing for surgical termination of pregnancy in the early stages has some peculiarities in comparison with medicamental methods. It is necessary to conduct a comprehensive examination of the woman on the armchair, to find out the possible length of pregnancy by the date of the last menstruation, and also to conduct additional research methods. It is necessary to conduct an ultrasound study that will enable you to determine exactly the duration of pregnancy, the exact location of the fetal egg and the presence of concomitant pathology, which is necessary for further tactics of determining the very process of abortion. A very important stage of preparation is the bacterioscopic examination of the smear from the vagina. This allows to exclude the inflammatory process and makes it possible to carry out invasive interventions without the risk of an ascending infection of the internal genital organs. It is this preparation that excludes the development of possible complications in the future - this important advantage of a qualified termination of pregnancy, in contrast to home unreliable ways.

Vacuum extraction of the fetus is an operative intervention for the abortion of a pregnancy up to eight weeks of pregnancy. This procedure is called so because of the technology for carrying out this type of intervention. In this case, under general anesthesia, most often, first the opening of the cervix with prostaglandins or laminaria. This allows further interventions. Then a special device with a sensor under ultrasound control is injected with an apparatus that is focused at the attachment site to the endometrium of the fetal egg. This device is connected to a device that has a high power and attracts a fetal egg like a vacuum cleaner, but it is 30 times more powerful. Thus, the fermentation of the fetal egg takes place, and it is absorbed, leaving the focus on the endometrium. After that, bleeding is usually small, oxytocin can be used to stop it, but this is necessary. That's the whole procedure, which takes a little time, and if there are no complications, the woman the next day you can let go home.

If the gestation period is more than eight weeks, especially if it is more than twelve weeks - then perform a surgical operation on the uterus. At the same time, they must conduct training, then general anesthesia. The technique of the operation is reduced to the curettage of the uterine cavity with a special instrument - the curette. The disadvantage of such an operation is that the doctor does not see what he is doing from the inside, and also the whole functional layer of the endometrium is injured. After this, the woman should be under the doctor's supervision for some time, since the risk of developing bleeding during such surgery is higher.

Interruption of pregnancy at a period of more than twelve weeks is carried out taking into account the fact that the fetus already has a formed placenta and parts of the body. In this case, a small Caesarean section with transvaginal access or stimulation of preterm delivery can be performed. Stimulation can not be done if there is a history of a cesarean section or a scar on the uterus. In this case, transvaginal surgery is performed. The technique of this abortion is as follows. Introduce the woman into general anesthesia. Then, after the opening of the cervix by special means, amniotomy is performed - the already formed fetal membrane is opened. Then, when the fruit with the water descends to the bottom of the cavity of the small pelvis, its extraction is carried out with forceps or aspiration - thus, the fetus leaves the uterine cavity. If the fruit shell does not come out - you can stimulate uterine contraction using oxytocin - five or ten units of action.

These are the main methods of surgical termination of pregnancy in the early stages. They should prefer, if it is too late to carry out medical abortion, but it is necessary to prepare for this type of abortion.

Consequences and complications of early termination of pregnancy

Spontaneous termination of pregnancy in the early stages often happens with those who want to keep the pregnancy. This is a miscarriage and can be the cause of bleeding in the first trimester of pregnancy. Therefore, it is necessary to know what are the main signs of this phenomenon. Signs of interruption of pregnancy in the early stages often appear suddenly, it can still provoke physical stress. In this case, there is pain in the lower abdomen, aching, pulling, acute character, which is accompanied by bloody discharge from the vagina of varying severity. This may also be nausea, vomiting, dizziness, a general disorder, a decrease in blood pressure. All this must be taken into account and immediately seek help.

As for the consequences that can be after the termination of pregnancy - they can be early and late. The early consequences are those that are caused by the very procedure of abortion and this is most often bleeding. This is due to the fact that it is difficult to control the effect of the drug and the dose in order to cause a sufficient reduction in the uterus, but this reduction should not be excessive. Therefore, it is necessary to observe the woman for the appearance of such complications. More serious complications are incomplete abortion, after which parts of the fetal membranes remain in the uterus. This can lead to a dense ingrowth into the uterus of the decidua and the formation of a bubble drift. This is a very dangerous pathology, which is characterized by malignant growth and poor prognosis. Therefore, it is necessary to monitor surgical abortion or medication by ultrasound.

There can be different inflammatory complications with ascending infection or with a lesion from a chronic foci of infection. This complication is manifested by an increase in temperature in the early postoperative period, an intoxication syndrome, and also secretions from the vagina of a purulent nature. This requires taking serious measures and prescribing antibiotic therapy. Sometimes, if a woman has chronic foci of infection, antibiotics can be prescribed as preventive measures to prevent the development of such postoperative complications.

Later complications of termination of pregnancy in the early stages appear with a subsequent attempt to become pregnant. In this case, adhesive processes can form in the uterus cavity, which complicate the process of egg migration and fertilization. These complications occur more often after surgical curettage and with several abortions. This is a very serious complication that requires long-term infertility treatment and it is not always effective.

The rehabilitation period after abortion without complications in the professional sense lasts for three days, and it is possible to issue a sick leave for this period. But the rehabilitation of the reproductive system of a woman lasts much longer, and especially it concerns the mental state. Restoration of the uterus and its functional inner layer occurs during the month until the next menstruation, when all the remains of the fetal egg and the damaged endometrium can come out with particles of menstrual flow. Then there is an involution of the enlarged uterus. Also speaking of the ovaries, they begin to function normally a month after the abortion.

Psychic rehabilitation of a woman should include moral and ethical moments of support from her husband, as well as from the attending doctor - this is an important stage in the recovery of a woman who should not be neglected. If necessary, you need to seek advice from a psychoanalyst.

Care of the genitals after the abortion can be carried out as usual, but it is desirable to adhere more hygiene measures, as well as hygiene of sexual life with temporary exclusion for the period of rehabilitation until the next menstruation. Pregnancy should be postponed no earlier than six months, and preferably one year after the artificial termination of pregnancy.

Interruption of pregnancy in the early stages is a very important step, which must be considered and resolved on it with the least damage to one's health. Therefore, a comprehensive examination, consultation of a gynecologist is necessary and only after this it is necessary to proceed with the choice of the method. Methods of termination of pregnancy in the early stages may be medication - up to 49 days of pregnancy, and then it is better to give preference to surgical ones. Alternative methods, although they exist, but do not use them without consulting a specialist because of the high risk for their own health.

trusted-source[14], [15], [16], [17], [18]

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