How is medical abortion in the early stages. How is a medical abortion performed? In the video about interruption

Medical termination of pregnancy sometimes saves a woman from maintaining an unwanted pregnancy. Scientists have been looking for a way to have an abortion without instruments for many years. Ukrainian gynecologists have been using medical abortion since 2004.

Preparing for medical abortion

Preparation includes a smear on the flora and intravaginal ultrasound to determine the gestational age and location gestational sac. It also states that the woman has chronic diseases which may be contraindications for medical interruption. Before the procedure, do not eat anything salty and fatty, smoked, after a medical abortion, you can not take a bath and go to the pool until everything is over. You can not eat 3 hours before the interruption and less than 2 hours after.

Effectiveness of medical abortion

Medical termination of pregnancy is manifested as more painful than usual, monthly. Interruption efficiency - 95%. The advantage of medical abortion is that it does not require general anesthesia. You just get a pill and drink it in front of a doctor. After 72 hours, you go back to the clinic, where you are given a pill to contract the uterus. A day later, heavy bleeding begins.

Terms of medical termination of pregnancy

Terms of medical termination of pregnancy: 5-6 weeks. Medical abortion is done after a complete gynecological examination. Side effects: nausea, headache. Contraindicated in heart disease with severe heart failure, tuberculosis, hypertension and myoma, obesity and diabetes.

How is a medical abortion performed?

Medical termination of pregnancy begins with a preliminary conversation between a woman and a 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 swab for flora and do an ultrasound scan to clarify the time. The woman signs the consent.

As for pain, it all depends on the period: the longer the gestational age, the more intense the pain.

After a medical abortion, a woman is selected for contraception. Conception can occur immediately, so you need to start protecting yourself 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 the doctor, indicating that she wishes to have an abortion. drug. Food is not accepted for 3 hours.
At the reception, the doctor does an ultrasound.
You are being warned about possible complications procedures and contraindications to it, conduct an introductory conversation.
Together with the gynecologist, you choose one of the drugs produced in France or Russia.
Tests may also be ordered if you did not do them shortly before the interruption. Results are ready in 1 day.
The drug is taken with a doctor.
Within 72 hours, pain and discharge similar to menstruation appear.
After the onset of pain and bleeding, prostaglandins are taken. Within 5 days, the fetal egg comes out entirely.
The next stage is the control ultrasound.

Remember that the vagina is a home for bacteria. That's why smears are done before medical abortion. When the cervix opens, bacteria can enter the uterus. Unfortunately, sometimes there is a toxic shock with a fatal outcome, but this is stubbornly silent.

Choose a clinic whose doctors have been performing the medical abortion procedure for a long time. This will help keep complications to a minimum.

Medical abortion pills

Tablets for medical termination of pregnancy: Mifepristone, Mifegin, Mifeprex, Mifolian, RU-486. The active substance of all these drugs is mifepristone. It is a complex molecule that has a complex effect on female body, configured to maintain pregnancy. If you had an irregular menstrual cycle before taking the pills, the problem may worsen.

Medical abortion is carried out with drugs that include Mifepristone: Mifegin, Mifeprex, Mifolian, RU-486. Specialists always carefully prepare a woman to take these drugs. The doctor discusses with the patient the anamnesis, all the diseases that she had or has.

Mifepristone

Mifepristone blocks hormone receptors that support pregnancy.

Medical termination of pregnancy with mifepristone is better tolerated than surgery. Before the procedure, you confirm that you are aware of what may be required in the future. surgical abortion because of incomplete removal fertilized egg. After taking mifepristone, on the 2nd day you come to the clinic again and take another drug that expels the embryo within 1 hour. Bleeding continues for 10 days, after which you come for a follow-up ultrasound. In rare cases, after taking the drug, diarrhea, dizziness and nausea are possible.

Mifepristone has the following contraindications:

Pregnancy while using an intrauterine device.
Scar after caesarean section.
Leiomyoma.
Insufficiency of the kidneys, liver.
Violation of blood clotting.
Anemia.
Asthma.
Diseases of the female genital area.

After taking, severe pain in the lower abdomen, dizziness and vomiting may be observed. The temperature may rise greatly. Do not take any painkillers and antipyretics - they can stop the abortion. You can take analgin or no-shpu in last resort. Better call the doctor who performed the abortion. You will be given emergency telephone numbers where you can get advice. If for some reason you cannot contact this doctor, with severe pain, constant vomiting and fever, call an ambulance.

Mifegin

Medical termination of pregnancy with mifegin is an alternative to curettage. Unsuccessful result, incomplete extraction of a 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 on the armchair, consultation of the patient, signing the appropriate paper - consent to the abortion, ultrasound to confirm the period and the first pill. The next visit is due in 72 hours. During this visit, the fetus is expelled from the uterus by taking a prostaglandin. In the clinic you need to be under observation for 1.5 hours. If the pain is very severe, you may be given a no-shpu. Short-term diarrhea is possible.

After 12-16 days, you need to do an ultrasound. If for some reason the pregnancy persists, a normal abortion is performed.

In the intervals between visits, you can not visit the sauna and drink alcohol.

Pencrofton

Medical termination of pregnancy with pencrofton is an alternative to surgical abortion. Advantages of medical abortion with the Russian drug Pencrofton:

Early termination of pregnancy on the second day after conception (for example, if you have been a victim of violence).
No risk of contracting hepatitis, as happens with abortion, if the instruments are poorly sterilized.
Lower cost.
Curettage can cause uterine scarring or perforation, life-threatening bleeding. This is not the case with pencrofton.
Fertility is restored immediately.
No anesthesia needed.
You don't have to go to the hospital.
Reduced risk of depression after an abortion.

The drug was developed in 1990. It expels the embryo from the uterus, opening the cervix. Termination 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 is sent home. Then, after 72 hours, she is given a drug that expels the fetus, which has stopped developing during this time. After 16 days, ultrasound is performed and curettage if necessary (rarely).

When taking pancrofton, there is a minimum side effects, as a rule, it is only nausea and a feeling of weakness, a slight increase in body temperature within 4 hours.

Misoprostol

Medical termination of pregnancy with misoprostol in Kyiv can be done in many specialized clinics. Misoprostol is the latest generation of abortion pills. As a result of the work of the uterine muscles under its action, the fetal 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 scheme for the procedure drug interruption pregnancy today - 600 mg of mifepristone with the introduction of prostaglandins 36-72 hours later.

Duphaston

Duphaston after medical termination of pregnancy is prescribed in the post-abortion period. On the 16th day, after the ultrasound, Dufaston is prescribed 10 mg twice a day for 10 days. Duphaston is an active progestogen. It is used in a number of gynecological diseases. When it is taken, there are no unwanted hormonal disorders. Duphaston does not affect liver cells and blood pressure.

Together with Duphaston, the gynecologist may prescribe you multivitamins or special vitamin complexes used in stressful situations. Abortion, whether surgical or medical, is stressful for a woman. As a result, not only nervous system but also the heart. Sometimes post-abortion psychosis develops. The first reaction is always relief. But then a woman often feels remorse, her self-esteem decreases, on this day every year she can cry. It helps to understand what happened. You can mourn your child. The support of loved ones is very important, but, unfortunately, the husband cannot always understand why the wife suddenly became cold with him. The process of finally getting rid of guilt is a long one. Medical termination of pregnancy is usually more easily tolerated by women, does not affect the state of mind so much.

Consequences of medical abortion

The consequences of medical abortion are reduced mainly to nausea, diarrhea and delayed menstruation up to 12 weeks, headache, chills, endometritis. Extremely rare side effects such as Quincke's edema, uterine rupture and toxic shock. 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, it happens, 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 set up to carry a pregnancy. Medical termination of pregnancy artificially stops this process. Therefore, neuroses are so frequent, the so-called. post-abortion syndrome. Rarely associated with medical abortion thyroid gland, explaining everything by the accident at the Chernobyl nuclear power plant. But in vain. The thyroid gland is involved in the regulation of hormones that support pregnancy, albeit not as clearly as the ovaries and pituitary gland. It is clear that they go for an abortion out of desperation, 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 made by any method, a woman's the immune system. Harmful bacteria from the vagina can enter the uterus. The risk of infection is especially high from the vagina, because it is located closest, but theoretically, the infection can enter the uterus through the bloodstream from any focus in the body, even a carious tooth.

Of course, the listed consequences most often occur during surgical abortion. But even with medical abortion, the cervix opens when the fetal egg is expelled. Through these gates, infection easily penetrates.

To minimize the consequences, medical abortion should end with a rest for your body. You can’t play sports for a month, no sexual intercourse, take a shower and don’t swim in open water, don’t go to the sauna, swimming pool, don’t take a bath earlier than 3 weeks after a medical abortion.

Harm

Harm medical abortion caused by blocking progesterone receptors. There is no injury to the uterus, so complications are much less common than with traditional abortion. Frequent complication- incomplete expulsion of the fetus (about 10%). Possible long uterine bleeding. Cases of toxic shock after taking "pregnancy pills" are known.

Complications

It is rare, but still possible, to face serious complications after 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. Allergy is possible. When any warning signs you should immediately seek advice from the clinic where the abortion was performed.

Allocations

Discharge after medical termination of pregnancy is usually brownish, bloody and often disturbing even if heavy bleeding already over. To remove all suspicions, be sure to visit a gynecologist and do an ultrasound on the 14-16th day after the abortion. If a month and a half after a drug 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-pill or combined).

You should also pay attention to the yellow discharge. This may be a sign of purulent inflammation, which has developed due to the fact that you carried a dead child in you for some time. yellow discharge after a medical abortion may be a sign of the reproduction of Escherichia coli.

Bleeding

Medical abortion is considered the most in a safe way However, this does not mean that it is harmless. Sometimes it happens that after an abortion develops profuse bleeding. It can lead to life-threatening blood loss. In this case, you need to lie down and call ambulance without hiding the fact that you had a medical abortion. Normal is considered a small, no more than menstrual, bleeding until the onset of menstruation after a medical abortion. If you have to change more than one night pad in an hour, seek medical attention.

pain

Pain after medical termination of pregnancy in each woman is of varying intensity. They are caused by contraction of the uterine muscles. How severe the pain will be depends on the pain threshold and gestational age. Pain medications for unbearable pain should be prescribed by a doctor because many of these drugs can suppress abortion. Pain after a medical abortion lasts for two days. Pain that is slightly more intense than normal menstrual 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 an infection in the uterus, a control ultrasound on day 16 must be done, even if you do not have any complaints. Abdominal pain, fever, green and curdled discharge These are all signs of an infection. Medical termination of pregnancy, done in accordance with all the rules, in three visits, rarely leads to such consequences. 98% of cases of complications during medical abortion are associated with ignoring medical recommendations.

Temperature

The temperature after medical termination of pregnancy usually rises no higher than 37.5ºС and lasts no more than 4 hours. Temperature up to 37.2C can last about 10 days. It is associated with increased levels of progesterone. Delaying the treatment of a possible infectious process in the uterus leads to infertility. Blood clots and fever, excessive bleeding should be the reason for ultrasound pelvic organs earlier than the period prescribed by the doctor (usually 14-16 days after the interruption). If you have a temperature and feel unwell after the abortion, call the doctor home.

Nausea

Nausea after medical termination of pregnancy is not observed in all women and not for long. If you vomit within an hour after taking the drug, unfortunately, the pills will not work. You will be referred for a vacuum abortion.

If a woman is very worried about pain in the lower abdomen, she may be prescribed no-shpu. 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, fatigue, fear, tachycardia, pruritus. Contraindications: individual sensitivity, intestinal obstruction, epilepsy.

Recovery after medical abortion

Recovery after medical termination of pregnancy should include a number of activities. Abortion is a serious injury, no matter how it is carried out. After a medical abortion, give yourself Special attention within 2-3 months. Don't lift weights. Ask your family members to help you clean up. The gynecologist can prescribe you procedures, gynecological massage. Be sure to visit the physiotherapy room if the doctor has advised you to do so. After an abortion, vegetative-vascular dystonia and nervous disorders can progress. Avoid stress and colds - medical abortion weakens the body's defenses. From 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 power loads, sports. You can have sex after the first period after an abortion. Mifepristone is incompatible with alcohol intake. We also recommend a mammogram.

Sex

Medical termination of pregnancy, since 1999, was done by every second woman. Alas, these are statistics. A small number of women do not have abortions in their lifetime. Bloody discharge after that lasts another two weeks. At this time, of course, you need to abstain from sex. The risk of inflammation increases if this recommendation is not followed. The same goes for intimacy during menstruation.

Pregnancy

It is advisable to plan pregnancy after medical termination of pregnancy no earlier than 3 months later. An earlier pregnancy has a higher risk of complications. Medical termination of pregnancy in 95% does not affect further opportunity conception, you can become pregnant in the next cycle, so take care of contraception. After a medical abortion, immunity is often impaired, so if you do not restore the body, you can pick up some kind of infection during pregnancy. Menstruation after medical termination of pregnancy Menstruation after medical termination of pregnancy is normally restored immediately. A delay of up to 20 days is considered normal. But in 70% of women they come on time. With severe cramping pains during menstruation after a medical abortion, you need to consult a doctor - this happens if the embryo is not all out.

You can also make a pharmacist by contacting the Kyiv clinic "Demetra" (Poznyaki district). It also performs colposcopy of the cervix and preventive examinations of women at affordable prices, treatment of STDs, menopause, menstrual disorders. Remember that with a latent course of diseases there are no pronounced symptoms, such as bleeding and pain in the lower abdomen. Regular check-ups help to avoid serious illnesses, incl. oncological. Cancer never develops on healthy tissue.

The center performs 300 types of tests. Here you can comfortably undergo rehabilitation after a medical abortion, get psychological help if necessary.

The Atlanta Medical Center is also located on the left bank of the Dnieper in Kiev. Here you can undergo a medical termination of pregnancy in the early stages (6-7 weeks). Also, the center treats sexual infections, gynecological and venereal diseases, conducts gynecological and general massage.

In the clinic "Clinic Doroslikh" on Lepse Boulevard in Kiev, you can make a medical termination of pregnancy by affordable price 1200 UAH (ultrasound included). Here you will find understanding. Gynecologists of the center know that a woman of any age is not 100% immune from 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 pass according to all the rules prescribed in the protocol of the pharmacist. The medical abortion clinic uses the long-established, reliable and effective drug Mifepristone. It is well tolerated by women. After the end of bleeding, you will definitely go through a control ultrasound again.

Worked well too medical Center"Vemar" on the street. N. Bazhana (Kyiv). This is where medical abortion is performed. early term- up to 42 days from the 1st day of menstruation. Normal sizes uterus, the absence of an embryo on ultrasound and discomfort during the follow-up examination indicate a successful medical abortion. The doctors of the clinic do their best to minimize side effects. Gynecologists of the center also treat colpitis, vaginitis and inflammation of the uterine appendages, polyps and endometriosis. The urologist of the center provides assistance in the treatment of kidney diseases and Bladder, as well as inflammatory diseases of the prostate and sexual disorders in men.

As you can see, the choice of medical clinics that provide medical abortion is wide. The method of medical abortion is called by WHO as the most gentle for women's health.

Medical termination of pregnancy is latest way early termination of pregnancy, which does not require surgical intervention and less dangerous to a woman's health than classical methods. Of course, many will ask why it is necessary to terminate a pregnancy at all, because a baby is happiness for a mother, but they forget that there are times when a child appears at the wrong time, or as a result of rape, or its appearance risks leading to serious complications and, possibly, , mother's death. There are times when abortion is the only solution.

How is a medical abortion performed?

Its medicinal version is based not on the artificial removal of the fetus, but on the adoption medical preparations to block the main hormone that provides support for pregnancy - progesterone. With the help of mifepristone and prostaglandin, the following mechanisms are called into action in the body:

The receptors that produce progesterone are blocked.
The fruiting egg ceases to receive nutrition and stops in development, which leads to its rejection by the body.
The cervix begins to slowly expand and begins to contract, expelling the fertilizing egg.
From the vessels that used to feed the egg, blood begins to flow, which finally washes it out.
The uterus stops contracting and slowly returns to its previous state, blocking the open vessels.

In fact, medical abortion is an induced miscarriage and has advantages over surgical abortion.

Benefits of Medical Abortion

No penetration. It is not necessary to expand the uterus artificially, there is a minimal risk of infection, damage to the cervix or the mucous membrane lining it.
High probability of success. In 98% of cases, medical abortion ends successfully - this figure is higher than that of the vacuum method.
Minimal risks. Side effects appear only in a small number of women, and the inability to have children after it is a vanishing rare case.
Psychological comfort. Going under the knife is a big stress for a woman. The medical option does not require such sacrifice.
Short and easy recovery period. No need to take sick leave or vacation at your own expense - recovery will take only a few days and will not be too painful.
No need for anesthesia. This should please those women who are difficult to tolerate anesthesia.

Flaws

Term. Medical abortion cannot be performed on later dates pregnancy, which means that a woman needs to have time to understand what is happening and seek help.
incomplete abortion. In some cases (fortunately, not very frequent), the fetal egg, no matter what, does not leave the uterus and you have to turn to other methods.
Possibility of pain. Because the uterus will contract to open and close, the woman may experience severe pain in the pelvic area. Also, the bleeding may not stop for a long time.
Conditions. A woman who agrees to this type of termination of pregnancy is not admitted to the hospital, which slightly increases her risks.

Timing

Unlike other types, medical abortion can only be performed very early. 42 days from the date of the missed period, after it will be too late. Wherein the best term up to 4 weeks is considered, after which the risk of incomplete abortion increases, as well as other risks.

Possible complications and risks

The consequences of uterine abortion can be divided into several subtypes:

Short term. Occur immediately after taking the drug:
- Vomit. Together with the contents of the stomach comes out and taken pill, which means you have to take it again.
- Allergy. It is observed in a small percentage of women, but the risk is still there. It can be something harmless like a rash, or it can be more severe symptoms like seizures, angioedema, choking, scabies, and many other unpleasant options.
As a rule, avoiding such unpleasant effects, women stay in the clinic for a while after taking the drugs, so that if something happens, they can get help.
Medium term. Occur some time after taking the drugs.
- Strong pain. Due to the fact that the uterus opens and closes, uterine spasm and pain in the pelvic area may occur. In this case, it is advised to take no-shpu, which will relieve spasm and help get rid of pain.
- Bleeding. Bloody discharge after a medical abortion occur in any case - since a medical abortion is an artificial miscarriage, it is accompanied by bleeding in the same way as a normal one. However, it can be very strong or too intense - in this case, you should consult a gynecologist, and if we are talking about the dark time of the day, when not a single doctor is working - call an ambulance.
- Incomplete abortion. There is some chance that the fertilized egg will not come out and then you still have to have a surgical abortion.
- Unpleasant symptoms. Headaches, weakness, nausea and diarrhea, lack of appetite, fever - all this passes quite quickly, but can cause a lot of discomfort.
Long term. They become noticeable only after long term after taking drugs, and sometimes a woman may not even associate them with an abortion.
- Hormonal disbalance. Since abortion affects hormonal system, it can fail, and sometimes it is quite serious, which can be characterized by the fact that there are no periods after a medical abortion or drastic changes weight. If this happens, you should contact the endocrinologist and gynecologist.
- Inflammation and infection. A weakened body is a tasty prey for viruses. Usually characterized by fever and discharge.
- Infertility. As a rule, it does not occur by itself after a medical abortion, but appears due to hormonal failure or inflammation.

Consequences

As a rule, for most women, medical abortion can be done without unpleasant consequences. The risk of infertility is extremely unlikely and pregnancy after a uterine abortion will most likely take place without complications.
Possible, except that:

Complications. As a result medical error or susceptibility. But the chance of getting them is small.
Irregular development of the fetus. This option is possible only if the woman, not being completely sure of her decision, decides to interrupt the procedure right in the middle of the abortion. A child who is born after this may have unpleasant birth defects.

Otherwise, a medical abortion does not leave noticeable consequences, unless, of course, it is done in the presence of contraindications.

Contraindications for medical abortion

Too much long term. After 42 days, the likelihood of complications and incomplete abortion is too high - so high that it is better not to risk it.
Age. For girls under 18 years old, it is better not to use this method, since their body is not yet fully formed and a sudden intake hormonal drugs may cause disturbances. Women over 35 should also choose a different method, since there is a high likelihood of heart complications or hormonal failure.
Ectopic or doubtful pregnancy. With uterine contractions that will be caused by drugs, in any case there will be blood, and the walls can simply burst. At ectopic pregnancy any internal bleeding threatens the woman's life. In the absence of pregnancy at all, blocked progesterone will lead to an inevitable failure.
Hormonal disorders. If the girl was taking hormonal contraceptives, or has hormonal disbalance, combine it with drugs for abortion - not best idea. Everything can only get worse.
Diseases of the genital organs. Any tumors, fibroids and scars make medical abortion impossible, since the bleeding that has opened may not stop.
Lactation. It is impossible to feed a child during a medical abortion - feeding must be interrupted at least two weeks in advance.
Chronic diseases. Among them:
- Diseases of the hematopoietic system, in which the blood may not stop or not recover in the body on time, which is likely to lead to unpleasant consequences.
- Epilepsy. Taking drugs can trigger an attack.
- Kidney and liver failure - it is these organs that will have to deal with medicines in the first place, and diseased kidneys with a liver may simply not withstand such a load.
- Diseases of the respiratory system - in asthmatics, for example, an attack may begin.
- Pathologies of the cardiovascular system, as well as diabetes, obesity and high blood pressure.
- Inflammatory diseases of the pelvis.
- Cardiovascular insufficiency.
- Viral infection.
- Any weakness of the body - against the background of illness or constant stress.
Allergy to drugs, a list of which can be found below.

What drugs are used

Among the drugs used to terminate pregnancy are usually called Mifegin, Mifeprex, Mifepristone, Pencrofton and Mifolian. Most of these drugs are Russian, and each of them is based on the same active substance - mifepristone - which blocks the receptors that produce progesterone.

Where and how can you get a medical abortion

Most of the complications that a woman experiences during a medical abortion occur when it is performed too late or without the participation of a professional. Therefore, the first step is to go to the gynecologist (of course, you should first call the clinic and find out if medical abortion is done in their institution) at the first suspicion of an unwanted pregnancy.

Preliminary analyzes

Smear. Based on it, the doctor can find out if there is reproductive system women disorders, inflammation and infectious diseases.
Tests for syphilis and HIV, as well as a blood test for beta-hCG, which will determine the presence of pregnancy.
ultrasound. Which will allow not only to determine the presence or absence of pregnancy, but also the location and number fruiting eggs, And possible diseases uterus.
Cardiogram. It is not done for everyone - only for those who have suspicions of cardiovascular disease.
Blood clotting test. Allows you to identify possible diseases of the hematopoietic system.
Analysis for urogenital infections.
When a woman has passed all the tests and if they have not revealed any contraindications, she can choose a convenient day for a medical abortion. On this day, it is better to refrain from heavy food, and before that, do not drink alcohol for two days and, preferably, do not smoke.

Direct abortion

In the morning, a woman comes to the clinic and receives the drug prescribed by her doctor, after which she remains in place for two hours so that the doctor can have time to react if something goes wrong. After two hours, she goes home and, at the appointed time, drinks the rest of the pills. There is a dilatation of the uterus and a miscarriage.
Three days after the miscarriage occurs, the woman undergoes an ultrasound so the doctor can make sure everything went well.
She has another ultrasound two weeks later to make sure her uterus has closed safely and everything is back to normal.

Recovery

In the first month, you need to take care of yourself and:

Do not visit baths, pools and saunas.
Do not expose yourself to too much physical stress.
Eat properly.
follow vaginal discharge(even normally they can last a month). If they become too abundant or acquire bad smell- see a doctor.
Sex after medical abortion is contraindicated until the moment when the first period after it passes.
If the menstrual cycle does not return to normal after three months, you need to take tests for hormones.
It is worth refraining from pregnancy for six months - it will become too serious a burden.

How much does a medical abortion cost?

The cost of medical abortion ranges from 7500 to 11000 and depends on the clinic and the drug used.

Pregnancy is not always planned. According to statistics, every third woman had an abortion at least once in her life, every 7 uses such a procedure as a contraceptive. There are several ways to get rid of an unwanted pregnancy, the most gentle among them is medication. When making such a responsible decision, you need to remember about possible consequences, and before taking such a step, weigh all the pros and cons. Medical termination of pregnancy has a number of contraindications and side effects. After the procedure, specialist supervision is necessary.

Benefits of Medical Abortion

The first such procedure was carried out in 1985. Since then, more than 1,000,000 women around the world have used it. It is noted that they perceive this procedure much easier than vacuum or surgical abortion (curettage).

Benefits of medical abortion:

There is no need to stay in the hospital for a long time.
The uterine cavity is not injured.
The risk of infection entering the uterine cavity is minimal.
The likelihood of complications (endometritis, adhesions) is small.
Anesthesia is not required. Medical interruption is a relatively painless procedure.
The method is suitable for young women who have never given birth.

These advantages and the seeming simplicity of the process push many women to the risky step of going through medical abortion on their own. And this despite the fact that medicines for this are sold only by prescription. Such actions are erroneous, they can only be explained by female carelessness or ignorance of the risks associated with taking such drugs. Although each of them has detailed description(instruction) indicating all possible side effects and complications.

Indications, contraindications, side effects

The older a woman gets, the less effective medical abortion is. The indications for the procedure are often young age, lack of previous pregnancies short term - up to 6 weeks.

The list of contraindications is quite impressive:

The fact of pregnancy was not confirmed by ultrasound.
Age: under 18, over 35.
Usage oral contraceptives within 3 months before the intended termination of pregnancy.
Ectopic pregnancy.
Irregularity menstrual cycle before the onset of pregnancy.
Endometriosis, neoplasms of the genital organs.
Anemia, hemophilia.
allergic status.
epileptic seizures.
Problems with the adrenal glands.
Long-term use of cortisol and similar drugs.
Insufficiency of kidney function.
Liver failure.
Diseases of the digestive tract.
Diseases of the lungs and bronchi.
Pathology of vessels and heart.
Bad habits - smoking, drinking alcohol.
Elevated BP.
Diabetes.
Allergy to the main substance of the pills that will need to be taken to terminate the pregnancy.

The medical method of interruption, in addition to contraindications, has a number of side effects. Most often observed:

Headache.
Nausea, vomiting.
Drawing, sometimes severe, pain in the lower abdomen.
Genital infections.
Profuse uterine bleeding.

Possible consequences

Medical abortion is not as safe as some private clinics make it out to be. In about 50% of cases, the procedure has significant complications for the woman's body:

Incomplete abortion. Particles of the fetal egg remain in the uterus, causing inflammation. As a result, the woman will still have to endure curettage.
Heavy bleeding. One of the reasons is the jamming of the fetal egg in the cervical canal. If a woman does not immediately seek medical help, there is a high probability of extensive blood loss.
The occurrence of heart failure. As a rule, this is an unforeseen reaction to taking drugs. It happens quite rarely.
bacterial infections. Normally lives in the human body a large number of various bacteria, some of which are conditionally pathogenic. While the immunity of a woman is normal, they do not manifest themselves in any way. However, the medical method of abortion deals a heavy blow to him. As a result, microorganisms such as clostridia get the opportunity to penetrate the cervical canal and multiply uncontrollably, spreading throughout the body and causing through a short time toxic shock.

Procedure steps

How is a medical abortion performed? The procedure can be divided into 5 steps:

Visiting a doctor, examination, testing.
Taking the first pill of three (mifepristone).
Taking the second tablet of three (mifepristone).
Taking the third pill (Mirolyut) is an optional step, it is prescribed by a doctor based on observations of the course of the interruption process.
Control examination after 2 weeks.

Doctor visit and examination

This step is required. In addition to a conversation with a specialist who can ask a woman to think about her decision, she will have to pass several tests. Only one ultrasound is not enough, in addition to it, the doctor gives a referral to:

Blood test to determine the Rh factor and group.
Blood test for hCG (human chorionic gonadotropin).
A smear for pathogenic microflora.
Tests for the definition of HIV infection, hepatitis, syphilis.

After receiving the results, the doctor will be able to make a conclusion about the advisability of the procedure.

Taking mifepristone medications

How is a medical abortion performed? A woman is given 3 tablets to drink - two based on mifepristone (Pencrofton, Mifegin, Mifiprex), the third Misoprostol or Mirolut - according to indications. Between doses of mifepristone, an interval of about a day should be maintained. So much is needed to start the process.

Mifepristone tablets are taken under medical supervision. A day later, or as the doctor indicates, the woman comes to the hospital again (it is better to do this on an empty stomach) and takes the second pill. The patient is under the supervision of a specialist for several hours.

Then she is sent home. At the same time, a woman should have at hand the telephone number of the attending physician, so that in case of an unforeseen situation she always receives emergency assistance.

The response to taking mifepristone preparations is individual for each patient. Some people experience spotting after a few hours, while others can experience it in a day or two.

Taking prostaglandins

According to statistics, in about 60% of cases, the third stage is omitted. In 40% of women, it is necessary to stimulate the contractility of the uterus to expel the fetal egg. To do this, they need to go to the doctor again, preferably on an empty stomach, and take Misoprostol or Mirolut (prostaglandins) under his supervision. The uterus will begin to contract, getting rid of the already dead embryo, bleeding will begin, similar to menstruation, only more abundant and prolonged.

Control reception

The woman's torment does not end there. After the medical interruption, she needs to return to the attending physician for a check-up in 2 weeks, or earlier if she feels any problems in her well-being.

The hospital will conduct an ultrasound examination of the uterus, which will determine whether the medical abortion was successful, or whether particles of the fetal egg remained in the organ and inflammation began. The news for the patient may be that even after bleeding, the fetus remained in the uterus and continues to develop, in other words, the pregnancy has survived. In this case, the doctor will suggest alternative methods abortion. Leave the germ after exposure to such strong means it is forbidden.

Recovery

Further actions of a woman should be aimed at normalizing her condition. For this, the doctor may prescribe vitamin and mineral complexes, folic acid, intravenous vitamin injections, immunomodulators, antibiotics if inflammation is observed.

In addition, after medical interruption, it is necessary to abstain from sex for a month and always use modern methods contraception. Other recommendations include:

Exclude visiting the pool until full recovery.
Do not use tampons for a month.
Do not overcool or overheat.
Do not engage in strength training.
Do not take alcohol.

Do not try to terminate a pregnancy on your own with over the counter pills or folk methods. This is fraught not only with infertility in the future, but also with a fatal outcome.

For almost all women, pregnancy is a long-awaited and happy event. Unfortunately, our life is far from ideal, and sometimes two cherished stripes instead of joy cause panic, despair and thoughts about the need for an abortion. One of possible ways- medical abortion. But it is worth considering how long it is possible to terminate a pregnancy with pills and what consequences this will entail.

Medical abortion: indications, effectiveness

Abortion is a serious moral issue for most people. Every woman makes this decision based on family, religious, moral, financial, social and personal values. However, in addition to a conscious desire to get rid of the fetus, the decision to have an abortion can be influenced by the so-called. medical indications- when there is a high risk of an abnormal outcome of pregnancy or childbirth.

The doctor may insist on terminating the pregnancy if:

woman has serious physical illness or psychiatric disorders, which may worsen during pregnancy;
high chance of hereditary chromosomal abnormalities The child has;
the environmental conditions in which the woman lives may endanger the health of the patient or the viability of the fetus;
mother is addicted to drugs.

The doctor can provide information about the risks of pregnancy and childbirth, but the final decision is always made by the woman

IN last years medical abortion (pharmacological, chemical, tablet) is increasingly being used to terminate pregnancy in the early stages. The procedure is carried out without surgical intervention, with the help of special preparations - Mifepristone and Misoprostol.

Medical abortion is highly effective: for up to 8 weeks it is 98%, for a period of 8-9 weeks - 96%. At a later date, medical abortion is not used.

Unlike surgical methods, medical abortion does not injure the uterine mucosa, respectively, the risk of developing secondary infertility is much lower. In the vast majority of cases, there is no need for hospitalization. The woman's body recovers quickly, and she will be able to return to normal life within a day or two.

Mifepristone and misoprostol have been used in medicine for over 20 years. So far, there is no reliable evidence that they in any way affect subsequent pregnancies or general state health.

Medical termination of pregnancy: video

Preparation for the use of tablets in the early stages

Before starting the abortion procedure, the doctor must examine the patient and prescribe necessary examinations, including ultrasound and blood tests to determine the general condition of the body and the duration of pregnancy. Also, the doctor will find out if she falls into the group of women who are contraindicated in medical abortion.

Contraindications for medical abortion are:

gestational age more than 9 weeks;
use of an intrauterine device by the patient;
ectopic pregnancy;
allergy to at least one active substance;
serious health problems such as hypertension, asthma, diabetes, etc.;
long-term use of certain drugs, such as steroids or anticoagulants;
a long history of smoking in combination with age over 35 years;
age under 18 years old.

Among other things, the doctor must ensure that the patient has access to urgent medical care in case of serious complications.

Stages of medical abortion

The abortion procedure consists of several stages.

Taking Mifepristone

The first stage should take place in the clinic under the supervision of a qualified doctor. Mifepristone blocks the production of progesterone - a hormone necessary for the normal course of pregnancy - and causes the embryo to separate from the uterine wall. The cervix softens and opens. Nausea and pain at this stage are possible and should not cause concern. However, if a woman vomits within an hour after taking mifepristone, it is necessary to inform the doctor about this, you may need another dose of the drug. Sometimes bleeding occurs after using the remedy, but this does not mean that the abortion is completely completed and the patient does not need to take a second drug.
Mifepristone terminates pregnancy without physical intervention in the uterine cavity

Use of misoprostol

In the second stage (usually 48 hours after the first), you need to take Misoprostol, a drug that causes uterine contractions and promotes the expulsion of its contents. Some time after taking (usually after 2-3 hours), the uterus begins to contract, and bleeding occurs. For most women, heavy bleeding with clots lasts 4 to 5 hours, but in some cases this period may be longer. Your doctor may recommend taking antibiotics to prevent infection.

According to most women, an abortion at this stage resembles an early miscarriage or very painful periods (the shorter the gestation period, the easier the entire period).

Common symptoms are:

profuse bleeding with large clots;
cramps, abdominal pain;
nausea or even vomiting;
stool disorder;
dizziness;
increased fatigue;
sweating;
temperature rise to 37–37.5 °C.

If discomfort too intense, your doctor may suggest pain medication: usually Ibuprofen or Codeine (depending on the intensity of the pain). However, medications that can increase bleeding (such as Aspirin) should be avoided. For the same reason, to relieve pain, you can not take a hot bath, you should limit yourself to a warm shower.

Intensive pain can be relieved with analgesics

Especially clearly all the unpleasant sensations are manifested during the first days after taking misoprostol. After that, most patients feel much better.

After the end of the second stage, slight bleeding may continue for several weeks. During this period, it is not recommended to use tampons to avoid infections.

Check-up in a week

Seven to ten days after taking misoprostol, you need to visit a doctor for a follow-up ultrasound. This should not be taken lightly. At the follow-up examination, the doctor can identify problems that have arisen in the previous stages and begin appropriate treatment.

To avoid unpleasant consequences, you must adhere to some recommendations:

If you are breastfeeding, please be aware that a small amount of medication passes into breast milk. There is no reliable evidence that they harm the child, but manufacturers recommend interrupting breast-feeding for the entire period of the abortion.
No alcohol is to be taken and it is highly recommended to abstain from smoking until the abortion is completed.
You must not have sex, use tampons, swim, or take a bath for two weeks after the abortion is completed. Heavy physical work and hypothermia should also be avoided.
In most cases, doctors advise against trying to get pregnant for 6 to 12 months after an abortion. This time is enough to strengthen the immune system and stabilize emotional condition women.

Possible Complications

Complications after medical abortion are rare and, even if they do occur, are usually relatively easy to manage with the help of qualified doctors. These include:

incomplete abortion;
incomplete cleansing of the uterine cavity;
profuse prolonged bleeding requiring medical intervention;
infectious diseases.

In very rare cases, complications can be not only serious, but also life-threatening. Reasons for urgent medical attention are:

heavy bleeding for two and more hours, in which more than two maxi pads need to be changed per hour;
larger clots chicken egg for more than two hours;
cramps and pain in the abdomen that are not relieved by painkillers;
a temperature of 38°C or more that persists for more than 24 hours after taking misoprostol;
weakness, nausea, vomiting and / or diarrhea that lasts more than 24 hours after taking misoprostol;
absence of bleeding after using misoprostol during the day.

Medications for medical abortion

There are a number of drugs that are used for medical abortion. Although they are not meant to be sold freely, they can be bought from some online pharmacies. However, I would like to warn against their independent use. Only a qualified doctor can assess all the risks in each specific case and carry out the procedure with the least negative consequences.

Prices for medicines depend on the country of origin.

Mifepristone preparations can be found on the market under the following trade names:

All of these drugs are most effective at gestational age up to 42 days. Reception schemes may differ in different medical institutions, but manufacturers recommend taking mifepristone 600 mg once under medical supervision. The remedy should be consumed on an empty stomach or at least two hours after a light breakfast.

Misoprostol preparations:

Misoprostol (China);
Mizotab (India);
Mirolut (Russia).

Misoprostol 400 mg is taken on an empty stomach 48 hours after mifepristone.

Emergency contraceptives

A common misconception is that drugs emergency contraception and pills for medical abortion are the same thing, is erroneous. In fact, the former prevent pregnancy after unprotected intercourse. The latter are used to terminate an existing pregnancy.

Emergency contraceptives contain a dose of hormones that delay ovulation and thereby prevent conception.

The most famous include:

All emergency contraceptive drugs must be taken no more than 72 hours after unprotected contact.

Medical abortion is a chance to save your health, as women in many countries of the world know how an artificially induced miscarriage occurs - at least 31st, where it is allowed at the legislative level this procedure. It is efficient and accessible.

Terms of medical termination of pregnancy in Russia are limited to six obstetric weeks. This is due to the fact that it is at such an early date that the greatest chance is to carry out the procedure without any complications, as painlessly as possible for a woman and effectively.

Advantages of the procedure compared to instrumental abortion

1. Does not require intravenous anesthesia. Thus, it avoids many problems associated with its side effect. For women, for example, a fairly common and significant consequence of anesthesia is profuse hair loss.

2. Does not require being in stationary conditions. Although some women, on the contrary, want to terminate the pregnancy with a medical method in a clinic, as they are afraid that the pain will be too strong, or heavy bleeding will begin.

3. Excludes trauma to the cavity and cervix. This means that the risk of miscarriage does not increase. next pregnancy. Does not increase the risk of infertility.

4. Psychologically better tolerated by most women. Since you do not need to go to the hospital, prepare for this procedure for a long time, see the surgical instruments that perform the abortion. All this is very mentally difficult.

5. Minimal risk of occurrence inflammatory process in the uterus - endometritis. Since they don’t “climb” into the uterus, they don’t injure, everything goes by the type of menstruation.

We can definitely say that the consequences of medical abortion, compared with instrumental, are minimal. And it is this type of abortion that is preferable for nulliparous women.

At the doctor's

You need to find a clinic, private or public, that is licensed to perform this procedure (almost everyone is now).

In the clinic, you will be examined and an ultrasound of the uterus will be done. This study is considered the main one, as it shows that the woman is really in position and the pregnancy is uterine.

Sometimes it happens that a woman comes after receiving positive result pregnancy test, but the doctor does not find a fetal egg in her uterus. This happens with a very short gestation period, usually when the delay has not yet begun. Now on sale there are tests with very high sensitivity, showing correct result not on the first day of the delay, but much earlier - 4-5 days before it starts. HCG level yet very small. To visualize a fetal egg, its level must reach at least 1000. And tests show correct result already at 10 units... The hCG level doubles every two days. It usually reaches this level already in the first week of delay. A pill abortion can be done with a delay of up to 2 weeks. There is time.

If the ultrasound showed a fetal egg in the uterus, the doctor gives a detailed description of how the medical termination of pregnancy occurs, what you will feel and how to behave. After talking with the doctor, you need to read and sign the informational consent, which will contain approximately the following points:

that the pregnancy is deliberately terminated;
in case of progression of pregnancy after taking the pills, it is advisable to interrupt it, as there is a great risk to the health of the child;
information on how the medical termination of pregnancy is carried out has been received in full;
complications may occur in the process - bleeding, not complete miscarriage, sometimes it is required to carry out additional curettage of the uterus or vacuum aspiration;
exacerbation of chronic infections can be provoked, resulting in infertility;
the woman undertakes to strictly comply with all the recommendations of the doctor.

Description of the procedure

Medicines for medical abortion are given by a doctor. The first, "Mifepristone", a woman takes in the presence of a doctor. A serious drug that blocks the action of progesterone - a hormone necessary for the development and nutrition of the fetal egg. This medicine is not sold in pharmacies in the dosages required to terminate a pregnancy. To avoid criminal abortions, as well as to make sure that the drug has worked, the woman should not vomit for 2 hours after taking it, the patient is asked to remain in the clinic for this time. And an information sheet is given with you, explaining what happens after taking the pills and how to act, the doctor's phone number, by which you can get advice at any time, and the second drug, synthetic prostaglandin. It must be taken at home 36-48 hours after the first one.

And if after "Mifepristone" a woman could have a maximum of bloody discharge from the genital tract, then prostaglandin provokes a direct detachment and release of the fetal egg from the uterus. All this is accompanied by severe cramping pain. The effect appears almost immediately after taking it. Therefore, you need to stay at home. After a miscarriage, the pain subsides.

Some women are also concerned about nausea, vomiting, diarrhea, chills, and fever. These symptoms do not occur in everyone, this is an individual reaction of the body to the medication.

As painkillers, "No-shpu", "Baralgin" are recommended - that is, drugs from the group of antispasmodics and analgesics. But Ibuprofen, Diclofenac, Aspirin and other non-steroidal anti-inflammatory drugs should not be taken, as they can weaken the effect of drugs given by a doctor.

Allocations after medical termination of pregnancy are abundant, stronger than during menstruation. Rarely, acute bleeding occurs. This is if it is completely saturated in an hour sanitary napkin, and this continues for 2-3 hours in a row. Then you need to urgently seek help. Doctors usually prescribe a hemostatic drug.

After a miscarriage, the discharge becomes much more abundant. However, they can be stored in small quantities for up to 14 days. Around this time, an ultrasound scan is performed, which should confirm a complete miscarriage. Otherwise, the woman is waiting for vacuum aspiration. Signs incomplete miscarriage are pains in the uterus and ovaries, fever body, prolonged bleeding, unpleasant smell from the vagina, etc. Incomplete abortion leads to endometritis. And that to infertility, in the absence of treatment.

menstrual cycle after artificial miscarriage most women don't get lost. That is, menstruation after medical termination of pregnancy should be expected at the usual time. And if a woman has started taking oral contraceptives, then there will be no problems with calculating the start date of critical days. They will start 3-7 days after taking 21 birth control pills. Since few people plan pregnancy after medical interruption in the near future, this is a wonderful way out. And the cycle will be restored, and there will be no more abortions.