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Termination of pregnancy at a later date
Last reviewed: 23.04.2024
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Interruption of pregnancy in later terms is not possible simply by the desire of a pregnant woman. This requires medical and social indications: serious deviations in the child, ugliness, if the husband is dead, and the woman does not work.
Indications for termination of pregnancy in later periods
The interruption of pregnancy in later terms is indicated for heart defects, kidney diseases with a decrease in their function, tuberculosis, cancer, rubella, suffered during pregnancy, severe diabetes mellitus, schizophrenia, chronic beacon disorders, schizoaffective disorders, mental retardation, Alzheimer's disease, muscular dystrophy . Indications from the fetus: absence of the brain, severe developmental anomalies, chromosomal pathologies.
Social indications for the termination of pregnancy: the death of a husband during pregnancy, the presence of a woman in custody at her desire to terminate a pregnancy, pregnancy as a result of rape.
In the United States, a sociological study was conducted, the purpose of which was to identify the reasons that prompted women to go to a late abortion. In the first place was the following reason: the women simply did not know about their pregnancy. This often happens if a woman is breastfeeding. During lactation often there are no menstruation, a woman considers this a norm and does not even suspect that she is pregnant. Some of the women interviewed simply took a long time to decide on abortion, until the term of 12 weeks simply did not come out. Some of them were afraid of the reaction of the parents or partner to their pregnancy. There were other reasons - some women wanted to keep her husband with the help of a child, because the marriage was falling apart, and they did not succeed.
Since 1998, abortions from 12 weeks have been banned in Azerbaijan, Armenia, Belarus, Georgia, Greece, Kazakhstan, Cuba, Lithuania, Moldova, Norway, Russia, Slovenia, Tunisia, Turkey, Ukraine, France and the Czech Republic. From 13 weeks abortion is banned in Italy, with 14 - in Austria, Hungary, Germany, Romania. From 18 weeks - in Sweden. In all the countries listed, it is permissible to have an abortion later than the specified period only as an exception. Exactly what exceptions are implied depends on the country.
Methods of abortion at a later date
Interruption of pregnancy in later terms occurs by the introduction of a saline into the uterus, after 2 days, miscarriage occurs. To interrupt pregnancy use a solution of NaCl or glucose, if for some reason the use of salt is impossible or contraindicated. The amount of solution administered is 6 ml for each week of pregnancy. The effect occurs within 17-22 hours.
You can use an extraamnial method of introducing a solution. However, with extraamnial administration, abortion may not occur. This method of abortion is resorted to later. There may be a lethal outcome due to excess sodium in the blood.
Sometimes they use prostaglandins and antispasmodics. The method is not suitable for serious diseases of the respiratory system, heart, liver, kidney pathology. Prostaglandins are administered extraamnially and intraamnially. If there is bronchospasm and hypotension, adrenaline and atropine are injected.
Interruption of pregnancy by the introduction of gramicidin C. The puncture needle through the anterior vaults of the vagina is amniocentesis. Pumps 20 ml of amniotic fluid and injected with 5 ml of diluted alcoholic solution of gramicidin C.
Prostaglandins are prescribed according to the following scheme: Dinoprost - intra-ammonium 25 mg every 6 hours or 40-50 mg once. Dinoprostone - intramuscularly - 2.5 - 10 mg once. An extraaminoal solution of 1.5-5 μg per ml is administered at a rate of 20-150 μg / h with an increase in dose of 10 μg / h, if necessary every 15 minutes (for 36 hours). Vaginally - 20 mg in 3-6 hours.
Very rarely do a small cesarean section. The incision is made in the lower segment. To the born viable fetus does not apply therapeutic measures. The child dies. Complication of a small cesarean section - thromboembolism. The method is preferred if sterilization is to be performed.
Interruption of pregnancy in late terms are carried out only in hospitals, where for this there are all necessary conditions. In the course of the abortion and after it, control ultrasound is performed. Without this condition, the development of sepsis is possible. Nevertheless, complications can occur: perforation, i. E. Perforation of the uterine wall, placental polyps, inflammatory diseases of the female genital area, which require a very long, expensive treatment.
[Forecast of termination of pregnancy at a later date
It is legally prescribed that abortion after 12 weeks can be performed only by an obstetrician-gynecologist of the highest category. This again confirms how risky this operation is.
During the procedure, in any way, sometimes there is such a heavy bleeding that the uterus must be removed and blood transfusion done. Also, endometritis and endometriosis often occur, ovarian infections, adhesions in the fallopian tubes, hormonal failures. Any of these causes often leads to the inability to have children in the future.
A full preliminary examination reduces the risk of late abortion.
If you have serious medical or social reasons to terminate a pregnancy, you should contact the family doctor and obstetrician-gynecologist at the clinic. They confirm medical and social indications for abortion and issue a conclusion with a diagnosis that indicates the timing of pregnancy and a positive decision on the termination of pregnancy of a special medical commission. You are put in a hospital. After discharge, the sick leave is issued for 6 days. Also, you will need to visit the precinct gynecologist for a short time to select a contraceptive.
Be sure to go through a course of antibiotic treatment, which you will appoint a doctor.
The topic of late abortion is always very difficult from the ethical point of view. Because late abortion is murder. Remember that interruption of pregnancy in the late term is an emergency measure, it is not performed by everyone, since it is a dangerous operation.