Medical treatment is being done. What happens after a medical abortion. The procedure takes place in several stages

The preservation of the reproductive health of a woman provides for the gentle conduct of all gynecological procedures. This also applies to abortion. It is known that the earlier the procedure is carried out, the less dangerous the complications. It is optimal to completely abandon this manipulation, but this is not always possible. Therefore, it is recommended to perform an abortion with the help of medications with a short gestational age.

What is a medical method?

The replacement of a surgical instrument and a vacuum aspirator with hormonal preparations made it possible to develop a technique pharmacological abortion. This is a non-invasive procedure for getting rid of early pregnancy, which proceeds according to the spontaneous type.

Its benefits are related to the following factors:

efficiency 98-99%;
no possibility of injury to the uterus or cervix during surgical procedures;
low risk of ascending infection;
there is no danger of getting HIV, hepatitis;
there are no risks caused by anesthesia;
can be used in primigravida, effect on women Health minimum;
low level of stress, does not create a traumatic situation.

The procedure does not require a long stay in a hospital. After the patient has taken drugs that cause medical abortion, bleeding can be expected at home. But self-administration of medicines without a doctor is impossible.

Which is better, vacuum abortion or medical?

This is decided individually. But the complications and degree of intervention in the body with vacuum aspiration are much higher.

How is the time for an abortion determined?

Deadlines for medical abortion are determined by the protocol of the Ministry of Health of the Russian Federation dated 10/14/21015. They recorded that it is possible to carry out a violation of gestation up to 63 days, or the 9th week. But in world practice there are differences in how long this manipulation can be done. In developed countries, the term is 49 days, or 7 weeks of pregnancy.

Why is such a period defined for pharmacological interruption?

At the 5th week of pregnancy, the embryo begins to acquire human features, the rudiments of many organs, the umbilical cord, appear. At week 6, the placenta begins to form, development continues internal organs. At week 8, the embryo is already quite human in appearance, it passes into the fetal stage. After this period, the formation of placental vessels occurs, so medical abortion can cause profuse bleeding.

Registered and used in Russia the following drugs for medical abortion:

mifepristone 200 mg.
Misoprostol 200 mcg.

Pharmacological abortion can be used if the gestational age corresponds to the permitted protocol. The main condition for the successful completion of the procedure is the day of pregnancy and the presence of an embryo inside the uterus according to the results of ultrasound. After a caesarean section, the drug method is preferable to.

Preparation for the procedure

At the first visit to the gynecologist, you need to conduct a general examination, a bimanual examination on the chair and in the mirrors, swabs are taken from the vagina. Also measured arterial pressure, pulse, respiratory rate. Next, the woman is sent for an ultrasound to establish exact day gestation, uterine conditions, gestational sac.

Referrals for blood, urine, glucose, ECG tests are given. A coagulogram is prescribed if there was a history of problems with the blood coagulation system. May be needed additional methods examinations, the need for which is determined by the doctor.

Execution Method

When visiting the obstetrician-gynecologist again, the patient signs a consent to perform an artificial abortion using pharmacological preparations. How medical abortion works is determined by the clinical protocol.

With a gestation period of up to 63 days, 200 mg of Mifepristone is used, which a woman drinks with a doctor. Within 1-2 hours, a doctor's supervision is necessary, after which you can go home.

If the period is 49 days, on the next visit after 24-48 hours, take 200 micrograms of misoprostol. During pregnancy 50-63 days, 800 mcg of the drug is used. This medication should be placed under the tongue, behind the cheek, or deep in the vagina. At the last way the introduction should lie down for 30 minutes. The patient should be observed for 3-4 hours. During this period, most begin to bleed. If this does not happen, the Misoprostol 400 mcg tablet is repeated to achieve the result.

The signs of abortion are the same spontaneous miscarriage. A woman feels a cramping pain in her stomach, menstrual-like discharge appears.

How long does the bleeding last?

In most women, it is expressed and lasts 7-9 days. Blood discharge after the procedure is rarely observed until the next menstruation. If the manipulation is carried out for a period of 3-4 weeks, then bleeding is not much different from menstruation. With an increase in the period, the release of blood increases, sometimes the use of hemostatic therapy may be required.

After 14 days, you need to come for a follow-up examination. This is necessary to confirm the completed interruption. If there was an unsuccessful medical abortion, then aspiration from the uterus is prescribed.

Contraindications

Above medications have serious side effects. Despite a high degree security, there certain contraindications for medical abortion:

gestational age exceeds 63 days;
diagnosed;
large fibroids that change the internal cavity of the uterus;
infectious diseases genital organs in the acute period;
anemia with hemoglobin less than 100 g/l;
porphyria - a disease associated with a violation of the metabolism of the constituent hemoglobin pigment;
bleeding disorders, as well as taking anticoagulants;
individual intolerance to one of the drugs;
insufficiency of the adrenal cortex or long-term use of glucocorticoids;
diseases of the liver and kidneys, which are accompanied by acute or chronic insufficiency;
severe diseases of other organs;
extreme exhaustion;
smoking at the age of a woman over 35;
arterial hypertension;
bronchial asthma;
glaucoma;
diabetes mellitus and other diseases of the endocrine system;
hormonally active tumors;
lactation period;
pregnancy with or after taking oral contraceptives.

On the recommendation of WHO, interruption with the use of mifepristone is possible up to 22 weeks, but the severity of bleeding increases in parallel with the term. In this case, for the duration of the procedure, the patient is hospitalized in a hospital, where there is a deployed operating room and it is possible to provide emergency surgical care.

Fibromyoma threatens to develop bleeding, but if the size of the largest node is up to 4 cm and they do not change the uterine cavity, then a pharmacological method can be resorted to.

Anemia is also a relative contraindication. The consequences of medical abortion can be manifested in a decrease in the concentration of hemoglobin: bleeding after taking medication exceeds the volume and duration of the menstrual period.

Violations of hemostasis are important for the volume and duration of blood loss. If, shortly before the manipulation, a woman was treated with anticoagulants, then an increase in blood clotting time will lead to more profuse bleeding. Women over 35 who smoke are at risk of developing thrombosis and disease of cardio-vascular system. Therefore, in order to exclude complications, a consultation with a therapist is carried out.

Use of oral contraceptives long time before the onset of pregnancy also affects the hemostasis system. But this contraindication is relative. If the results of the coagulogram do not reveal pathological abnormalities, then this method of interruption can be used.

If the pregnancy occurred against the background of the installed IUD, then it is removed before the procedure. Further tactics do not differ from the standards.

Infection of the genital organs is a pathology that requires appropriate therapy, which should not be delayed. Medical abortion does not promote ascending infection, and treatment acute infection can be carried out simultaneously.

Mifepristone and misoprostol penetrate into breast milk. If there is a need to interrupt breastfeeding, then you need to express milk up to 5 days after taking misoprostol. The child at this time is transferred to artificial feeding.

Bronchial asthma, high blood pressure and glaucoma are diseases that respond to prostaglandins. Therefore, in these pathologies, the use of misoprostol is contraindicated.

In addition, the contraindications for each drug should be taken into account. For the most part, they are the same as above. You can only supplement the careful use of misoprostol in patients with epilepsy, atherosclerosis of cerebral vessels, coronary heart disease.

Possible Complications

Despite the small number of complications, it is possible to determine the dangers of medical abortion. In 85% of cases, adverse reactions in the form of abdominal pain and bleeding are moderate, no special treatment is required.

In other cases, manipulation can lead to the following complications:

severe pain syndrome;
profuse bleeding;
temperature;
incomplete abortion;
progressive pregnancy.

Pain in the lower abdomen is observed during the expulsion of the products of abortion. Its intensity can be different, but the individual tolerance threshold also matters. For decreasing pain syndrome apply Analgin, Drotaverin. The World Health Organization (WHO) recommends Ibuprofen for pain relief. If the chest hurts after an abortion, this may be due to a high level, which increases with the progression of pregnancy. This symptom goes away on its own.

Bleeding is considered significant if two pads have to be changed in an hour, and this condition is observed for at least 2 hours. In this case, vacuum aspiration of the contents of the uterus is indicated in order to stop it. In severe cases, surgical cleaning is performed.

In 2-5% of cases, the abortion is incomplete. Then it is also necessary to perform vacuum aspiration or curettage of the uterine cavity. Less than 1% of cases end with progression of pregnancy. If a woman insists on an abortion, then invasive methods are used. Those who have changed their mind should be informed about the possible teratogenic effect of drugs on the fetus. But there is not enough data to confirm this fact.

Taking drugs can cause a slight increase in temperature, but it lasts no more than 2 hours. If the fever lasts 4 or more hours or occurs a day after taking misoprostol, this indicates the development of an infectious process. A woman with these symptoms should see a doctor.

Infectious complications are not typical for pharmacological abortion. But there is a group of people who have an increased risk of infectious complications:

, established by smear;
patients with a sexually transmitted infection up to 12 months ago, but there is no laboratory confirmation of its cure;
patients diagnosed;
women with many sexual partners or low socioeconomic status.

Other complications in the form of dyspeptic symptoms may be a sign of pregnancy itself. Allergic reactions require treatment with antihistamines.

Recovery period

After taking Mifepristone and Misoprostol, there is no failure of the menstrual cycle. But it is difficult to predict when and how long menstruation after a medical abortion begins. The duration of the procedure matters, after more early interruption cycle recovery is faster.

The first menstruation can begin in 30-50 days. But the abortion does not affect the onset, therefore, in the first cycle, a new fertilization is possible. To avoid this, immediately after the procedure, the doctor prescribes combined oral contraceptives. It can be such means as Yarina, Regulon, Rigevidon, Novinet, Lindnet, Jess. Selection medicinal product happens individually.

Protects against unwanted pregnancy in 99% of cases. A positive effect is the regulation and restoration of the menstrual cycle. Minimum term for such contraception is 3 months, but you need to wait full recovery body to decide when to get pregnant. Usually this period is not less than 6 months.

If pregnancy occurs earlier, then this threatens with such complications as:

threat of interruption;
ectopic pregnancy;
anemia in women.

The advice of doctors on how to restore the body after a medical abortion is as follows:

start taking oral contraceptives early;
avoid overheating and hypothermia in the first month after the procedure;
do not visit the sauna, swimming pool, do not swim in open water;
do not take a hot bath, take a shower instead;
take care of your health, in season colds avoid crowds of people so as not to get infected;
nutrition should be balanced, with sufficient protein and vitamins;
completely give up alcohol, eliminate smoking;
should be limited at first. physical exercise. Those who are heavily involved in sports or fitness should temporarily refuse to visit the gym;
limit stressful situations and emotional overstrain.

Sex life after medical abortion is possible after the end of the first menstruation. The uterus after an artificial miscarriage is an extensive wound surface with a nutrient medium for microorganisms. Sexual contact is always a risk of infection. In addition, active frictions can deliver discomfort or lead to re-bleeding.

Physiotherapy has a positive effect on the recovery process. The choice of a specific method of exposure must be agreed with the attending physician, because. this method of treatment also has contraindications.

If the restoration of the menstrual cycle did not occur within 2 months, you should consult a doctor for an examination and search for the causes of hormonal failure. Unpleasant sensations in the mammary glands, which began to prepare for lactation, may also be disturbing. Therefore, in some cases, a consultation with a mammologist is recommended.

Despite numerous positive points, medabort is not ideal method. Any intervention in the internal environment can lead to unpleasant consequences. To avoid them, it is necessary to approach the issues and family planning correctly, and not solve the problem after it appears.

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 option is 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 different. high efficiency: for up to 8 weeks it is 98%, for a period of 8-9 weeks - 96%. For more later dates 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 body of a woman recovers quickly, and she will be able to return to normal life in 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;
patient use intrauterine device;
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 normal course 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, abortion at this stage resembles an early miscarriage or very painful periods (than less term pregnancy, the easier the whole 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 the pain is 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 need to follow some guidelines:

If you are breastfeeding, be aware that a small amount of the drug 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 manufacture.

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.

Sometimes it happens that a woman cannot bear a child for certain reasons, and conception has already occurred. For such situations, medical abortion is often used (pharmacological abortion, artificial interruption) - a procedure that is usually done in the early stages with the help of special pills. This variant of abortion is characterized by a minimum number of complications, compared with surgical methods. The effectiveness of pharmacological interruption is 98 percent, but only if it is carried out in a timely manner.

What is medical abortion

Abortion without surgical intervention called medical interruption of gestation, pharmaceutical abortion, non-surgical abortion. This procedure causes artificial miscarriage. It differs significantly from the surgical option, because special tablets are used for its implementation. The process does not require the use of anesthesia and invasion of the uterine cavity, which prevents a number of unwanted complications. Medical abortion is considered one of the most safe ways termination of pregnancy.

Indications

As a rule, a medical method of abortion is prescribed in such cases:

The woman herself refuses to keep the uterine pregnancy (gestation).
A condition that can threaten the patient's health and even life.
The location of the fetal egg in the uterine cavity, the exclusion of ectopic gestation.
The procedure can be carried out with wrong development fetus, the risk of genetic pathologies.
The woman is suffering from overweight, fibroids, erosion, endometriosis, has a pathology of the development of the uterus.
The gestation period is more than 22 weeks. During this period, pharmacological interruption is considered one of the most safe methods artificial abortion.

Advantages and disadvantages

A non-surgical way to interrupt gestation in a woman using pills has a number of positive qualities. Unlike surgery, medical termination of gestation has the following advantages:

minimal pain of the procedure (abortion is performed with pills without anesthesia);
abortion proceeds naturally, like menstruation;
after a pill abortion, the risk of complications is reduced;
unlike other methods of interruption, the chance of getting into the body of infections that are transmitted through the blood (for example, hepatitis, HIV) is excluded;
if medical abortion is used, then unlike surgical or vacuum abortion, it is excluded bad influence on the function of reproduction (i.e., infertility does not threaten the patient).

With all the advantages of abortion, which is carried out by means of pills, the procedure has several disadvantages:

in rare cases, not all of the fetal egg comes out of the uterus, some part of it may remain (the remainder is removed surgically);
early pregnancy pills sometimes cause uterine bleeding, periodically you need to use blood transfusion, curettage;
some patients are allergic to certain pills for non-surgical abortion;
since drugs for interrupting gestation are hormonal drugs, their effect on the body of patients is difficult to predict;
sometimes pain, discomfort in the abdomen, intestinal upset, nausea, fever, general malaise, severe weakness are recorded;
another disadvantage is the high cost of medical abortion compared to surgical abortion, but the price is justified by the result.

Contraindications

There are a number of restrictions on medical method interruption of gestation. Absolute contraindications:

infectious diseases chronic form at the time of exacerbation;
ectopic pregnancy;
termination of pregnancy is prohibited in the presence of gynecological acute diseases;
allergic reaction on the composition of medicines for non-surgical abortion;
the formation of a malignant oncological tumor;
unconfirmed gestation (without examination by a gynecologist and ultrasound);
blood diseases in a patient;
severe somatic pathologies of a chronic type (renal, liver failure);
bronchial asthma.

Relative contraindications for medical non-surgical abortion:

arterial hypertension;
uterine fibroids, endometriosis;
lactation period (you need to stop breastfeeding weeks before taking the drug);
scars on the uterus C-section);
smoking in patients older than 35;
pregnancy while taking hormonal drugs protection or use of intrauterine methods of contraception.

Timing

Farmabort, as a rule, is prescribed when a woman's menstruation is delayed for no more than six weeks (or 42 days from the first day of the last menstruation). This procedure is performed using special preparations in the form of tablets. The drug regimen is most effective at a gestational age of six weeks. It is quite possible to terminate a pregnancy in the early stages with pills, but in the later stages of gestation, the positive effectiveness of the pills is reduced to a minimum.

abortion pills

popular medications For non-surgical termination of pregnancy, the following pills are considered:

The main drug for pharmacological abortion is mifepristone. This name is international, the drug belongs to the group of antiprogestogens. Mifepristone blocks the activity of the hormone progesterone, which is needed to maintain gestation. Tablets are produced by a large number of pharmaceutical companies, so there are many derivatives of it (they are described below).
Pencrofton - pills that are considered an excellent replacement for the classic surgical abortion. The medicine removes the embryo from the uterus by opening the cervix. Pharmacological termination of pregnancy with this drug is carried out up to a period of 7 weeks. Pencrofton tablets practically do not cause side effects, in some cases, weakness and nausea are observed.
Misoprostol tablets are also used for medical abortion. They provoke the expulsion of the fetal egg by stimulating the uterine muscles. This drug is often prescribed to young patients who have not yet given birth. The success rate of abortion with Misoprostol tablets is 70-85%.
Pharmacological abortion with Mifegin is carried out in many countries of the world. Tablets have a blocking effect on uterine receptors, which causes fetal rejection. The uterus softens, its muscles contract, and the cervix opens, pushing out the fetal egg. Means for medical interruption of gestation Mifegin is most effective for up to 6 weeks. Side effects may occur after taking the tablets (probability 5-10%).
An analogue of Mifepristone - Mifolian, is an antiprogestogen steroid drug. It blocks the synthesis of the main hormone of pregnancy - progesterone, increases the contractile functions of the myometrium. Tablets are used to terminate pregnancy in the first stages (up to 42 days of amenorrhea). Sometimes the action of the tablets is accompanied by side effects: pain in the lower abdomen, headache, weakness, nausea.
Another drug for artificial abortion is Mifeprex. Tablets are used for up to 42 days. The main advantages of the drug are considered to be very good tolerability and high level efficiency. Some patients may go bloody issues within 2-3 days after taking the tablets.

Preparation

Before the procedure is carried out, the patient must be prepared. The doctor first talks with her, informs in advance about the contraindications to the procedure, talks about the likelihood of complications after it, about the essence of the non-surgical technique. Then the woman is sent for such examinations:

general analysis blood, urine;
complete examination by a gynecologist;
Ultrasound of the pelvic organs;
smears to detect vaginal infections;
blood donation for group, Rh factor, hepatitis, syphilis, HIV.

How does a medical interruption work?

Before a pharmacological abortion, it is forbidden to eat smoked, fatty, salty foods, and after the procedure, you can not take a bath or visit the pool. It is also not recommended to eat 3 hours before the termination of pregnancy. Non-surgical abortion is performed on an outpatient basis. Stages of implementation:

The patient is re-examined. Then the doctor gives the woman three tablets of the selected drug (containing mifepristone). After that, the patient is under the supervision of specialists for 2-4 hours. In some pregnant women, the release of the fetal egg occurs during the stay in the hospital, if this does not happen, then the patient is sent home.
At home, she takes pills - prostaglandins for 36-48 hours to fix positive result. The interruption should occur no more than three days before. Then the patient comes back to the doctor for an examination and passes the control ultrasonography.
The patient undergoes a second ultrasound in a couple of weeks. If it is found that there are remnants of the fetal egg in the uterus or the unwanted pregnancy continues to develop, then surgical abortion(curettage of the uterine cavity).

What happens after a medical abortion

If everything went smoothly for a woman, then after passing last ultrasound and consultations, she is prescribed contraceptives. They prevent pregnancy, and also contributes to active recovery hormonal background. If the interruption of gestation with pills went without consequences, then after six months you can conceive a child. If a situation arose due to which the uterine cavity had to be scraped, the doctor prescribes anti-inflammatory drugs and physiotherapy. After successful treatment, a woman, as a rule, becomes pregnant again.

Performance definition

The last visit of the patient to the doctor is carried out 2 weeks after taking the medication. The condition of the uterus is assessed by ultrasound, because the effectiveness of the event can only be detected by this method. The study helps to find out how effective the abortion was, whether there are any remnants of the fetal egg in the uterine cavity, how it looks. The effectiveness of the procedure will be maximum if all the instructions of the gynecologist are clearly followed.

Rehabilitation

Two or three weeks after a pharmacological abortion, a woman should be very careful about her well-being. If the body temperature rises, there are copious discharge with blood and severe pain lower abdomen, you need to urgently visit a doctor. When rehabilitation proceeds without the above consequences, it is worth avoiding hypothermia, colds, stressful situations, limit to a minimum physical activity. You can’t take a bath, douche, swim in the pool, river, sea. Exclude sexual intimacy until the next menstruation.

There are several methods to terminate a pregnancy on early term. Each of them has its own risks and contraindications. In the article, we will consider medical abortion, how the procedure goes, and whether there are any risks.

Until recently, vacuum or mini-abortion was the only way terminate the pregnancy in early period. But he had a lot side effects due to the fact that it was an intervention in the uterine cavity, which could lead to injury or infection.

That is why scientists have studied alternative ways interruption of the course of pregnancy, which do not require instrumental intervention. After the invention in the 80s of such hormonal agents as Mifepristone and Misoprostol, medical abortion became possible. How it all happens, we will consider further.

Medications for medical abortion

Today, there are many analogues of Mifepristone - Mifeprex, Miropristone, Mifegin, Pencrofton, RU-480 and others. These are progesterone antagonists, which, in addition to abortion in a certain dosage, can be used as emergency contraception (Ginepriston). The action of these drugs is to block the action of progesterone - the main hormone responsible for the development of pregnancy. In parallel with the above drugs, Cytotec is used to terminate a pregnancy. How to take the drugs depends on the situation. Therefore, the gynecologist should prescribe the dosage.

Misoprostol also acquired different trade names, also known in Russia as Mirolut. The prostaglandins contained in the preparation provoke contractions of the muscles of the walls of the uterus, after which the fetal egg is expelled from the cavity.

At what time and how is medical abortion done

The decision to have a medical abortion is made by the woman. The gestational age should not exceed 49 days from the beginning of the last menstruation. It should also be taken into account existing contraindications, among which:

suspicion of the development of an ectopic pregnancy;
renal or hepatic insufficiency in acute or chronic form;
long-term use of some hormonal drugs(dexamethasone, prednisolone, etc.);
taking anticoagulants;
exacerbation inflammatory processes in the urogenital system of a woman;
the presence of uterine fibroids;
the onset of pregnancy when using an intrauterine device or immediately after the abolition of oral contraceptives;
severe form of bronchial asthma;
individual intolerance to the components of the drugs.

During the first visit to the gynecologist, a woman undergoes gynecological examination and rents necessary tests including smears and blood tests. Ultrasound diagnostics of the pelvic organs is also necessary to exclude the risk of ectopic pregnancy. Before you make an abortion with a medical method, the doctor consults about possible risks. A woman signs a consent to the use of a particular drug for this purpose.

How is a medical abortion done? This will require three steps. On the first day after a light breakfast, a woman drinks 3 tablets of Miropristone or analogues with a dosage of 200 mg, remaining for several hours under the supervision of a doctor. At the end of this time, the patient is allowed to go home, but at the first fear that something is going wrong, she must call the doctor.

The second visit is 48 hours after the first dose. On this day, 2 tablets of Mirolut or analogues are taken with a dosage of 200 mcg. Within a few hours, bloody discharge from the vagina should begin. If they are not observed, Mirolut's reception is repeated. As a rule, the amount of discharge, as well as the duration, varies depending on the gestational age and individual features woman's body. Usually spotting is present for 1-3 weeks. Sometimes it may be necessary to take hemostatic drugs.

The third visit to the gynecologist is scheduled no later than two weeks after the second. The doctor conducts a follow-up examination and ultrasound to exclude the possibility of complications in the form of an incomplete abortion or a pregnancy that continues to develop. The doctor develops a method of preventing unwanted pregnancy for the future.

Medical abortion is the termination of pregnancy with the help of drugs, without gynecological intervention. It is carried out at the request of a woman, for a fee, according to the accepted scheme and only in clinics licensed to carry out this procedure. Now in Russia there are quite a few of them.

When is the procedure possible?

How long a medical abortion is done is described in official medical documents - this is 6 weeks, in Russia. Moreover, the period is considered from the first day of the last menstruation.

Specifically, from the day of conception (often ovulation), no more than 4 weeks should pass. It's 2 weeks late period. But the sooner the procedure is performed, the greater the chance of success.

How early to find out that pregnancy has come? You can take a blood test for hCG 1-5 days before the start of a delay in menstruation. Or do home test, only necessarily with high sensitivity. There are test strips showing correct result even 5 days before the start of a missed period. Moreover, their cost is small, about 50 rubles.

However, be prepared for the fact that before the start of a missed period, even if hCG level confirms that you are pregnant, no one will give you an abortion. Neither medical nor surgical. It is necessary that an ultrasound confirm the presence of a fetal egg in the uterus. And before the start of the delay, it is not yet visible there.

How abortion pills are carried out and its disadvantages

A woman needs to find a clinic where this procedure and make an appointment with a gynecologist. After confirming the uterine pregnancy and the appropriate time for the procedure, he will tell you how the medical abortion works in the early stages and issue an informed consent, which the patient must sign.

Next, she will be given a drug that she must take in the presence of a doctor. It is advisable to stay in the clinic for a couple of hours after this, but in practice, women are usually quickly allowed to go home, since the medicine is well tolerated, rarely gives side effects. These medical abortion pills are called mifepristone. After taking them, a very small number of women immediately begin to miscarry. Most people don't feel better. But there may be spotting, bloody discharge from the vagina.

After 36-48 hours, the woman should take another drug - Misoprostol. Again, this should by standards take place in the clinic, under the supervision of a doctor. And after taking this drug, after 20-30 minutes, severe cramping pains and bleeding begin. During this time, the woman should be in the clinic. If she vomits, this is one of the side effects of misoprostol - you may need to additional reception drug. Usually, within the next 2-3 hours, a fetal egg also comes out. True, it may not be noticed, since there will be many clots. As soon as the pain subsides a little, the woman is allowed to go home.

After 7-10 days, it is necessary to do an ultrasound to make sure that complications during early termination of pregnancy, and they are primarily in incomplete miscarriage, are missing. If particles of the fetal egg remain, or it continues to develop, vacuum aspiration is suggested. Even if the woman has already decided to leave the child. The fact is that due to the intake of "Misoprostol", those severe spasms that it causes, the child develops numerous malformations, such as defects in the skull, foot (horse foot), etc. And that's not all possible consequences medical abortion. Frequent complication there is heavy and prolonged bleeding. By the way, this complication after vacuum aspiration is observed much less frequently. The woman is forced to take hemostatic drugs. All this limits her ability to work.

Medical abortion also has contraindications:

ectopic pregnancy;
allergic reaction;
prolonged use of glucocorticoids;
adrenal, hepatic and kidney failure and some others. For example, a doctor may refuse this service if a woman has a large myomatous intramuscular node, since active uterine contractions that occur after taking Misoprostol can lead to tumor necrosis.

Restoration of the cycle, sexual life, contraception and new pregnancy

Discharge after medical abortion lasts about 10-14 days, more than during normal menstruation, or even after surgical termination of pregnancy. At the same time, determine whether the uterus is completely cleared of membranes can only be based on the results of ultrasound. If yes, menstrual cycle recover quickly. So, menstruation after a medical abortion in the early stages usually begins after 28-35 days. In this case, ovulation may already be in the middle of this cycle, so it is very important to immediately start using reliable contraception. Many are also interested in when it is possible to have sex after a medical abortion, after how many days. Doctors recommend only after complete cessation discharge, that is, after 10-14 days. But we will focus on the issue of contraception.

Modern doctors recommend for women living with one constant sexual partner, an intrauterine system (spiral) or oral contraceptives ( hormonal pills). In this case, the spiral can be installed directly on the days of bleeding after an abortion. The main thing is that by that time there are no fetal membranes left in the uterus. That is, you need to do an ultrasound, and if everything is fine, you can talk with the doctor about which intrauterine system you need. better fit, buy and install it. Intrauterine systems are installed in last days menstruation, when the cervical canal is ajar, so that the procedure is easier and more painless.

Oral contraceptives can be started within the first 5 days after a miscarriage. Strictly according to the instructions. Then the contraceptive effect will be good and will come quickly (how fast depends on the day of the cycle on which the drug was taken). Besides, hormonal contraceptives help restore hormonal background. Doctors often prescribe them after an abortion to take them for at least three months, or even before the start of pregnancy planning, if there are no contraindications to the pills.

Is it possible to terminate a pregnancy in this way on your own without going to a doctor

Many women and this option of abortion is not entirely satisfied. Expensive... And again, you need to go to the doctors. Therefore, they try to independently purchase drugs that, in their opinion, should “help”. Since there are no drugs necessary for medical abortion in the free market, they buy what is available. And this is Oxytocin. It is sometimes used for incomplete abortion or to intensify labor pains. But in early pregnancy, this drug alone will not help in any way. It will only lead to painful contractions uterus, possibly bleeding. But it is very unlikely that a miscarriage will occur, especially a complete one. And the remains of the membranes in the uterus is a direct threat of blood poisoning.

For this reason, in order to avoid severe complications, you should not cause a miscarriage on your own at any time.