Medical termination of pregnancy timing as it happens. Indications for medical abortion. Medical abortion: consequences

The news of the upcoming pregnancy does not delight all ladies. There are many reasons for this, from unplanned conception to poor health. In order to get rid of unwanted pregnancy Today, there are several ways. The safest drug is considered. This method excludes serious surgical intervention. It is better tolerated both physically and psychologically. In our article, we will talk about how medical abortion occurs. You will also be provided with information about possible contraindications and consequences of pharmacological abortion.

Description of the procedure

Medical or pharmacological abortion is a procedure aimed at terminating an unwanted pregnancy without major surgical intervention. It is carried out with the help of certain drugs. Their action is based on blocking the production of progesterone. This hormone is produced in the body of a woman and is responsible for maintaining pregnancy. After taking the pill, a spontaneous miscarriage occurs.

Medical interruption pregnancy, preparations for this procedure and its implementation - all these issues have been discussed by doctors for a long time. However, only since the end of the last century has it become possible to carry out pharmacological abortion effectively and relatively safely for a woman's health. Experts from France have developed the drug Mifepristone, which belongs to the group of antiprogestins. In the early 1980s, large-scale studies of this drug as an abortion drug were launched in Geneva. A few years later, in France, they began to put it into practice.

Numerous medical studies show that women prefer pharmacological abortion for a number of reasons. First, there is the fear surgical intervention. Secondly, this method allows you to hide an unwanted pregnancy from relatives and friends.

Advantages of pharmacological abortion over surgical

Medical termination of pregnancy, the timing of which is described below, has a number of significant advantages. We have already mentioned some of them earlier. For what other positive points worth paying attention?

No need to take painkillers.
Fast recovery period.
The probability of damage to the uterine cavity, the development of adhesive processes or other gynecological complications is excluded.
Medical abortion resembles heavy periods, so psychologically a woman perceives it as a natural process.
There is no need to go to the hospital.
The risk of infection with viral diseases (AIDS or hepatitis) is excluded.

To find out all the nuances of how medical abortion occurs, it is better to consult a gynecologist. The specialist will answer your questions and give useful recommendations.

Permissible terms

Pharmacological abortion can be carried out up to the 6th week of pregnancy, counting from the first day of the last menstruation. The effectiveness of the procedure increases markedly when used in the early stages. Otherwise, other interruption techniques (eg, vacuum aspiration or surgery) may be required.

What drugs are used?

Medicines for the procedure are selected by the doctor. At the same time, he must take into account the individual characteristics of the female body. The drugs used today can be divided into two conditional groups. The first includes "Postinor" and "Escapel". They are used for emergency contraception.

"Postinor" is available in the form of tablets. Its active ingredient is levonorgestrel. Once in the body, it causes certain changes in the endometrium, preventing the process of egg implantation. On the other hand, levonorgestrel suppresses ovulation. According to the instructions, "Postinor" must be drunk immediately after unprotected sexual contact has taken place. First you need to take one pill, and after 12 hours - the second. During the first few hours, its effectiveness is 95%. Within a day, this figure drops to 58%.

"Escapel" has a similar effect, but contains a large dose of levonorgestrel. Therefore, taking the medication is limited to one tablet. This difference between the two means and limited. They have the same effect on the ovulation and fertilization processes.

The second group of drugs includes "Mifepristone" and "Pencrofton". Their use is justified in case of pregnancy, the period of which does not exceed 6 weeks. They are used after implantation of a fertilized egg. Therefore, before prescribing these drugs, it is necessary to conduct a number of clinical studies.

The active ingredient is mifepristone. Its penetration into the body blocks the activity of progesterone, significantly increasing the contractility of the myometrium. As a result of these processes, the cervix begins to expand, expelling the fetal egg. Below we will consider how medical abortion occurs using the last group of medicines. "Mifepristone" and "Pencrofton" are used for this procedure most often.

Possible contraindications

There are a number of circumstances in which medical abortion should not be performed. Reviews of gynecologists warn that it is better to refuse the procedure in the following cases:

gynecological diseases of an inflammatory nature;
uterine fibroids;
long-term treatment with glucocorticoids;
blood clotting disorder;
lactation period;
ectopic first pregnancy.

Medical abortion is not recommended for women over 35 years of age. The drugs used may cause abrupt change hormonal background.

Preparation for the procedure

Pharmacological abortion is a serious procedure that must be carried out under the supervision of a doctor. After the appearance of signs of an unwanted pregnancy, you should contact a gynecologist for a preliminary examination. The doctor performs an ultrasound to determine estimated time conception. After that, the woman must give written consent to medical termination of pregnancy.

Preparations for the procedure are selected by the gynecologist. Before an abortion, a pregnant woman must also pass several tests, including a swab for flora. If cardiovascular disease is suspected, a cardiogram may be required. After that, the doctor sets the date of the abortion. Before this, it is better to give up heavy food, alcohol and smoking 24 hours in advance.

Stages of pharmacological abortion

After receiving the results of the analyzes, you can proceed directly to the procedure itself. How is a medical abortion performed?

In the absence of obvious contraindications, the doctor gives the woman a drink of the drug. As a rule, these are 3 pills of 200 mg each. The next visit to the gynecologist is recommended after 36 hours. At this stage, the fetus is expelled from the uterus. For this purpose, a woman is given prostaglandins, they must be instructed about the possible consequences. Sometimes she is asked to stay in the clinic for a day to monitor changes in her condition. A woman can be allowed to go home, provided that she adheres to the recommendations of a specialist, and if discomfort contact him immediately.

The first control ultrasound is performed 3 days after taking the drugs. If the remains of the fetus are visualized in the uterine cavity, the doctor decides how to proceed. The second control ultrasound is scheduled in 2 weeks. If necessary, the gynecologist gives direction to the analysis of the level of hCG.

Recovery period

Recovery after the procedure lasts about a month. At this time, you need special attention relate to health and wellness. Fever, pain in the lower abdomen, spotting after medical termination of pregnancy - all these symptoms should be the reason for a visit to the doctor.

After a pharmacological abortion, a woman's body undergoes serious changes. Recovering hormonal background, the reproductive sphere is rebuilt, immunity falls, the risk of developing inflammation increases. Therefore, it is necessary to take care of yourself, give the body time to normalize the work of the main systems.

Within 14 days after the abortion, you should refuse to visit the bathhouse, have sexual intercourse, play sports and use tampons. If you follow these tips, you can hope for a successful recovery of the body.

Bleeding after an abortion - normal or pathological?

Negative consequences of medical termination of pregnancy are extremely rare, but they are still possible. One of them is bleeding.

The appearance of blood clots after taking the first pill is considered normal. For 5 days, discharge is usually worn exuberant nature. After this period, they become more scarce, and then completely stop. For some women, spotting continues until the first menstrual period.

Their character depends solely on individual features organism. At first they may be scarlet in color, then dark and brownish in the end. It is necessary to control bleeding after medical termination of pregnancy, to monitor their volume. It is considered pathological to use more than two pads per hour.

In the presence of severe bleeding or with its abrupt cessation, you should immediately contact a gynecologist. If this is not possible, it is necessary to call a team of medical workers.

Complications of medical abortion

Pharmacological abortion is considered relatively safe procedure but it is not without its shortcomings. After taking medications, side effects may occur, including:

Pain discomfort. IN this case it all depends on the characteristics of the organism, the threshold of its sensitivity. Before the procedure, the doctor should talk about possible pain. To eliminate them, antispasmodics and analgesics are usually prescribed. It is not recommended to take medications on your own, you need to consult a doctor.
Nausea and vomiting. Pregnancy itself can be accompanied by such symptoms. Sometimes nausea and vomiting are caused by prostaglandins prescribed by a gynecologist. Similar side effects rarely observed, but they pass on their own.
Temperature increase. The consequences of medical termination of pregnancy of this nature are caused by taking medications. As a rule, the temperature rises to 38 degrees and lasts no more than 4 hours. If unpleasant symptom does not disappear, most likely, it is a consequence of the inflammatory process. You should tell your doctor about the change in well-being, who will already prescribe the appropriate therapy.
Diarrhea. This is a short-term side effect that does not require specific treatment.
Hematometer. This disorder is characterized by the accumulation of blood clots in the uterine cavity. Its development is preceded by a spasm of the neck of the reproductive organ. You can eliminate the violation with the help of medicines.

These pathologies rarely accompany medical abortion. Reviews of women who have undergone this procedure confirm this statement. Pharmacological abortion leaves almost no noticeable consequences if done in qualified specialist and in the absence of contraindications.

Service cost

Where is medical abortion performed? This question worries many women. This service is now provided by almost all medical institutions. It is recommended to seek her help in the hospital where your attending gynecologist works.

The final cost of the procedure may vary depending on the drugs used, the prestige of the clinic and the qualifications of the specialist. A certain role in this matter belongs to the woman's stay in the hospital after the gynecologist performs a medical abortion. The price of the service in this case can be from 7 to 11 thousand rubles.

Medical abortion is the use of two different medicines for termination of pregnancy: mifepristone and misoprostol.

The doctor prescribes and gives the first pill, Mifepristone, to be taken at the clinic. The action of mifepristone is the effect of progesterone at the receptor level. Pregnancy needs a hormone called progesterone in order for the fetus to grow normally. Mifepristone blocks a woman's own progesterone. During this, the doctor will also prescribe antibiotics to prevent infection.

The second medicine, misoprostol, is used 6 to 48 hours later, usually at home. This medicine causes cramping and bleeding to empty the uterus. This process is very similar to an early miscarriage.

This method is very efficient. For women who are 6 weeks pregnant or less, this method works about 98 out of 100 times.

When can this procedure be done?

You can usually have a medical abortion up to 42 days (10 weeks) after the first day of your last period. If 43 or more days have passed since your last period, you can have an abortion by other methods at the clinic to end the pregnancy.

Why do people choose medical abortion?

The woman herself can choose the method of abortion, depending on personal preferences and the situation. With medical abortion, some people like that it is not necessary to have the procedure in a doctor's office.

You can have an abortion at home or in another convenient place. The woman herself decides who she wants to be with during her abortion, or can do it alone. Because medical abortion is similar to a miscarriage, many women feel more "natural" and less invasive. A doctor can help a woman decide which type of abortion is best for her.

Research on this method shows that if a woman takes the first drug but not the second, the abortion pill is less likely to work. Therefore, if a woman started the abortion process with an abortion pill but then changes her mind about doing it, you should contact your doctor or nurse to talk about the next steps and what to expect.

Using misoprostol alone to induce abortions will be successful in 90% of cases.

Some women try to have an abortion by placing sharp or dirty objects into the uterus or punching the abdomen. It is very dangerous for life, because there is a very high risk injured internal organs women, infection, heavy bleeding and even death.

For many women, terminating a pregnancy is a difficult decision. When a woman cannot discuss abortion or alternatives with her doctor, discuss it with good friend or relative. It is recommended that any young girl talk to her parents or other adults whom she trusts with her situation, her decision and the abortion process.

How medical abortion works

Misoprostol for medical abortion works best in the first 6 weeks of pregnancy. After that, there is increased risk complications and the need medical care. Misoprostol is used to induce uterine contractions. As a result, the uterus excludes pregnancy. A woman may experience painful cramps, vaginal blood loss greater than normal menstruation, diarrhea, vomiting, and nausea. There is a risk of severe bleeding, for which you need to see a doctor.

The probability of a successful abortion with misoprostol is 90%. Misoprostol is available in pharmacies in almost all countries.

The experience and risk of misoprostol-induced abortions is similar to that of spontaneous miscarriage. Miscarriage occurs spontaneously in 15-20% of all pregnancies. Treatment of complications is the same as for spontaneous abortion (miscarriage). The tactics of treatment will be the same as with a spontaneous miscarriage.

Before you make a medical abortion procedure, a woman needs to make sure that she is pregnant. It is necessary to do a laboratory pregnancy test and undergo an ultrasound scan.

Medical abortion should only be used if the woman is 100% sure she wants to terminate the pregnancy. Before making an abortion, a woman must necessarily conduct an ultrasound scan, since ultrasound shows the localization of the pregnancy in order to make sure that it is uterine and shows the duration (number of weeks) of the woman's pregnancy.

This method should not be used after 6 or more weeks of pregnancy.

Pregnancy six weeks means 42 days (6 weeks) since your last menstrual period. If a woman thinks that she is pregnant for more than six weeks, or if the ultrasound shows it, then this method of abortion is contraindicated. The medicine still works, but the risk of heavy bleeding, severe pain, and complications increase with the lengthening of the pregnancy.

Procedure algorithm

First, a woman is examined to determine the possibility of this type of medical abortion. You cannot terminate a pregnancy with this method if a woman has one of the following conditions: ectopic pregnancy, polycystic ovaries, IUDs, corticosteroid use, adrenal dysfunction, anemia, bleeding disorders or use of anticoagulants, asthma, liver or kidney disease, heart disease, or high arterial pressure. Antibiotics must be taken during this procedure to prevent infection.

Mifepristone is taken during the first visit to the doctor. Mifepristone blocks progesterone, causing destruction of the lining of the uterus, preventing the possibility of continuing the pregnancy.

Misoprostol tablets are taken orally or inserted vaginally 36 to 72 hours after taking mifepristone. The pills will cause contractions and force out the fetus. This process usually takes several hours or up to several days.

A physical examination is done two weeks later to complete the abortion and check for complications.

Side effects and risks

Side effects and risks include the following:

spasms;
nausea;
vomit;
diarrhea;
heavy bleeding;
infection.

The procedure fails in about 8-10% of cases where an additional procedure is required surgical abortion to complete the abortion.

This method of abortion is contraindicated in the presence of such diseases and conditions:

anemia;
bleeding disorders:
liver diseases;
kidney disease;
convulsive syndrome;
acute inflammatory bowel disease;
when using an intrauterine device (IUD).

After taking the first dose of misoprostol, the patient should expect bleeding and convulsions. Bleeding usually starts within four hours of taking the tablets, but can sometimes occur later. Bleeding is often the very first sign of an abortion. If the abortion continues, the bleeding and seizures become more severe. Bleeding is often heavier than normal periods and there may be clots. How longer pregnancy the more severe the convulsions and bleeding. If the abortion is completed, bleeding and convulsions decrease. The moment of abortion can be seen with a peak of more severe blood loss and pain and cramps.

Bleeding after an abortion

Bleeding continues 1-3 weeks after the abortion, but sometimes shorter or longer. Every woman's body is different. A normal menstrual period usually returns after four to six weeks.

Some women bleed without abortion. Therefore, it is important that the woman is convinced that the abortion actually occurred. It may take two to three weeks before a pregnancy test becomes negative. Therefore, you need to undergo an ultrasound a week after the abortion to make sure that the pregnancy is over. It is normal for some blood and tissue to remain in the uterus after 7-10 days; it will come out with the next menstrual period. As long as there is no fever, pain, heavy bleeding, or vaginal discharge remaining in the uterus, this is not a problem.

Cases when you need to go to the hospital

You need to go to the hospital if:

If there is heavy bleeding. Severe bleeding is bleeding that does not stop for 2-3 hours or more, and absorbs more than 2-3 centimeters of a sanitary pad per hour. Feeling dizzy can be a sign of too much blood loss and means that there may be a danger to the woman's health.
If heavy bleeding does not stop after 2-3 hours, this may be a sign of an incomplete abortion (the remains of the fetus are still in the uterus), which needs treatment. This can happen a couple of hours after taking the drugs, but also two weeks after the abortion.
If fever occurs. Chills are a normal side effect of misoprostol, as well as some fever. However, if a woman has fever(> 38 degrees Celsius) for more than 24 hours or she has a temperature above 39 degrees, you need to see a doctor because an infection may occur as a result incomplete abortion, and it will take further treatment(with antibiotics and/or vacuum aspiration).

If the method didn't work

When there was no bleeding at all after taking the medication, or there was a little bleeding, but the pregnancy is still ongoing, this means that the abortion did not occur. There is a slight increased risk birth defects such as deformities of the legs and arms, and problems with nervous system fetus if the pregnancy continues after an attempted abortion with these medicines. Because of this low risk of birth defects, vacuum aspiration should be performed if pregnancy is not terminated after taking these medications.

If the abortion was incomplete, the woman may need dilatation and curettage (D&C) or vacuum aspiration, during which the doctor will remove any remaining tissue from the uterus.

After the method

Vomiting and nausea may occur after taking mifepristone. If you vomit within 1 hour of taking the pill, tell your doctor as soon as possible, as you may need to take the pill again.

The second medicine is misoprostol tablets, which are placed in the vagina. They can be placed in the vagina on their own, or with the help of medical worker. You should try to insert them as high into the vagina as possible. Do not worry about the exact position of the tablets in the vagina; it is not important for them that they are in a certain place in order to be effective.

The woman will also be given some antibiotics, pain medication, instructions for use, and advice on how to take care of herself.

Misoprostol tablets cause convulsions and bleeding in a woman. This usually starts 2 hours after using misoprostol, but it can start sooner.

Bleeding and convulsions usually last for several hours, and the patient will likely need pain relief at this stage.

During an abortion, a woman may see large blood clots or tissue. The fabric will be larger and recognizable on more high terms pregnancy. A 10-week-old fetus is the size of a large grape and a woman can recognize its shape. If the patient is concerned about what she may see when the abortion occurs, it is worth discussing this with the attending physician.

Most women terminate their pregnancy within 4 or 5 hours of taking medication. For others, it may be faster or take longer. Almost all women terminate their pregnancy within a few days.

It is normal to have bleeding up to 4 weeks post-abortion, it is recommended to use sanitary pads to make it easier to track the bleeding.

An IUD can be inserted by a doctor as soon as the bleeding stops and a pregnancy test shows negative result, or when an ultrasound shows no pregnancy. Oral contraceptives may be taken after the bleeding has ended, but they will not be completely safe for the first month. Use additional contraceptives such as condoms for extra protection during the first month.

The most gentle way to conduct an abortion is medical abortion. It is practically safe for health and emotional state women. For its implementation, drugs are used that provoke expulsion gestational sac out.

What is a medical abortion?

The term "farmabort" is used to denote the artificial termination of a pregnancy that has begun with the use of medications. The method completely excludes surgical intervention. During this procedure, the patient takes pills in the presence of a doctor. Under the action of the components of this drug, the death of the embryo occurs. This concludes the first stage of medical abortion.

Later certain time the woman is taking another drug. Its components provoke an increase in the contractile activity of the uterine myometrium. As a result, the rejected fetal egg is expelled outward, an abortion occurs. This procedure has a number of advantages over other methods (scraping,):

no trauma to the uterus;
quick recovery of the menstrual cycle;
low risk of complications;
does not require anesthesia.

Medical termination of pregnancy - terms

Answering the question of a woman, how long a medical abortion can be carried out, doctors call 6-7 weeks. Pharmabort can be carried out no later than 42-49 days from the moment when the first day of the last menstruation was celebrated. At the same time, the effectiveness of this procedure decreases over time, and the likelihood of complications increases.

Doctors call the optimal time for a medical abortion up to 4 weeks. The fetal egg does not have time to securely fix itself in the uterine wall, therefore it is better and faster rejected and released. In addition, the hormonal background has not yet been fully established, the restructuring of the body has not been completed, so it will be easier for him to return to the previous state, before pregnancy.

Medical termination of pregnancy - contraindications

The main indication for such termination of pregnancy is the desire of the woman herself. However, not all pregnant women and not in all cases can undergo medical abortion. In addition to the time frame indicated above, there are other contraindications to the implementation of the medabort:

allergic reactions to medications in history;
liver failure;
adrenal insufficiency;
pathological bleeding;
active inflammatory process in a woman's body;
pulmonary tuberculosis;
suspicions of;
oncological processes;
lactation process;
implementation of corticosteroid therapy;
blood coagulation disorders.

How is a medical abortion performed?

Talking about how the pharmabort goes, the doctor explains the stages of the procedure. Previously, a woman needs to undergo a small examination, which is prescribed on the day of treatment:

ultrasound of the uterus;
smear on microflora;
blood test for syphilis.

After receiving the results, the exact time is assigned when the medical abortion will be performed, the terms of which are indicated above. During a second visit, the doctor re-talks with the woman, clarifies the seriousness of her intentions, whether she has changed her mind. Then the patient is given a drug that she drinks in the presence of a doctor. Under the action of the drug, the growth of the endometrium stops, and the muscle layer begins to contract. The woman is observed for 2-3 hours, after which she leaves the clinic.

The patient is given a tablet of another drug that stimulates uterine contractions. Take it after 36-48 hours, as directed by the doctor. Under the action of the drug, the dead embryo is expelled outward. Only after this medical abortion is considered complete. A woman fixes spotting.

Medical termination of pregnancy - drugs

A woman, even if she wishes, cannot independently carry out a pharmacist - pills for its implementation are not sold in the pharmacy chain. When performing a medical abortion, drugs are used with a high content of hormones, so they are issued by a doctor in a medical facility. To carry out medical termination of pregnancy, the following groups of drugs are used:

Antigestagens- suppress the action of natural progestogens at the receptor level. The representative of this group is Mifepristone, Mifegin. For pharmaceutical use 600 mg of the drug.
Prostaglandins- increase the contractility of the uterine myometrium. More often from this group, Mirolut is used. 400 mg of the drug is prescribed. It is taken 36-48 hours after the antigestagen.

How to understand that the farmabort was successful?

Complications are possible with any medical procedure, therefore, women are often interested in doctors about how to understand that the honeybort failed. For the purpose of excluding possible violations after 14 days, the woman should visit the clinic and undergo a follow-up ultrasound. The doctor must make sure that the fetal egg, its remnants have completely left the uterine cavity. Examine the organ itself, determining the size. In a woman, the doctor specifies the nature of the discharge, the presence and severity pain syndrome. Often, after a pharmaceutical abortion, the test is positive - this is due to an altered hormonal background.

Menstruation after pharmaceutical abortion

Normally, menstruation after a pharmaceutical abortion comes in 28-30 days. Taking abortive drugs practically does not affect the hormonal background of a woman, so menstruation is not disturbed. However, in some cases, there is a change in the volume of secretions: they can be scarce or excessively abundant. So, a small amount of discharge after medical termination of pregnancy may be due to:

Small opening of the cervix during the abortion process - fragments of the fetus cannot normally come out, accumulating in the uterine cavity.
Incomplete abortion - the fetal egg is not completely rejected, and the fetus continues to develop.

Within 2-3 days, bleeding is observed after pharmaceutical abortion. Normally, it lasts up to 10-14 days. The fertilized egg is separated in parts, so the discharge lasts a long time. Their volume exceeds the number of menstrual. You need to be careful about the volume, making sure that they do not go into. Signs of such a complication are:

a large amount of blood secreted from the vagina - in half an hour sanitary napkin("maxi") is completely saturated;
pain in the lower abdomen;
dizziness;
skin blanching;
increase in the number of heartbeats;
lowering blood pressure.

Sex after pharmacist

After the pharmacist is carried out, what cannot be done and what rules to follow - the doctor explains to the woman. At the same time, special attention is paid to intimate life. Doctors do not recommend women to have sexual intercourse until the spotting stops. Otherwise, there is a high risk of infection reproductive system. On average, the period of abstinence should be 2-3 weeks from the moment of abortion.

Pregnancy after pharmaceutical abortion

Properly performed pharmaceutical abortion does not affect reproductive function. after such an abortion is possible already a month later, in the next menstrual cycle. Given this fact, doctors strongly recommend protection. Often women regret their deeds and wish to become pregnant again. In addition, there are cases when the interruption was carried out according to medical indications, so a woman wants to quickly get pregnant again.

The reproductive system needs time to recover, so you should refrain from planning a pregnancy for 6 months from the moment the medical abortion was performed. During this period, doctors recommend using. In this case, it is better to give preference to mechanical (condom), since the use hormonal drugs may affect the hormonal background.

Life circumstances often do not turn out the way we want, and dictate their own conditions. Sometimes pregnancy is unwanted or contraindicated for health reasons. In such a situation, there is only one way out - abortion.

In early pregnancy, doctors often use medical abortion, which is considered the safest for a woman's health. In the article we will talk about how true this information is, and what consequences the use of abortion pills can have.

And now let's dwell on this in more detail.

Drugs used for early abortion

The first drugs for medical abortion were invented in France at the beginning of the last century, today the country remains one of the main leaders in the production of drugs for abortion. Medical abortion is always performed under careful observation the attending physician, self-administration of drugs can be dangerous for a woman's health and lead to infertility. Please note that medical abortion is allowed to be done at the earliest possible date - up to 41 days from the beginning of the last menstruation. After that, other methods of abortion are used.

The main advantages of medical abortion are:

Minimal risk of infertility. Drugs, unlike curettage, do not injure the uterine mucosa, so the risk of infertility is significantly reduced.
No complications. Surgical methods abortions are often fraught with the development of inflammatory processes, cervical injuries, and with medical abortion, the likelihood of complications is minimal.
Ambulatory mode. At medical method hospitalization of the patient in the hospital is not required. Reception hormonal drugs leads to the fact that the embryo dies, the uterus contracts and the fetus is brought out. The body recovers quickly after such a procedure, the very next day a woman can return to her normal lifestyle.

Medicines that are used for medical termination of pregnancy are not commercially available; you can buy them only on the prescription of a doctor. The drugs are based on antigestagens, they are also called antiprogestins - this is a group of biologically active substances that suppress the action of natural progestogens at the receptor level. necessary for and ensuring its vital activity, suppressing it with special pills, a woman stimulates the rejection and death of the embryo.

The most popular antiprogestin on this moment mifegin or mifepristone is considered, which is used at a dosage of 600 mg once (3 tablets), the drug acts for three days. 36-48 hours after taking antiprogestins, prostaglandins are prescribed, for example, at a dosage of 400 mg. (2 tablets). While taking medication, a woman should be under the supervision of a doctor.

The list of drugs for medical abortion looks like this:

Mifepristone
Mifeprex
Mytholian
Pencrofton
Mifegin
Misoprostol

The active substance in all tablets is mifepristone, they differ from each other by the manufacturer, and, accordingly, by quality and efficiency.

Spontaneous miscarriage occurs within a week after taking the pills. The doctor controls the completeness of the miscarriage with the help of ultrasound. The cost of abortion drugs depends on the manufacturer, for example, the Russian drug Mifepristone is cheaper than French Mifegin or Chinese Mifepristone 72. On average, the price of these drugs ranges from 1000 to 5000 rubles. Every woman who decides to have a medical abortion should understand that the unauthorized use of drugs can cause serious side effects, so self-medication in this case is ineffective.

Carrying out scheme

Medical termination of pregnancy is not as simple a process as many might think. In fact, it is carried out in several stages and requires careful preparation.

Survey. First of all, the doctor should conduct an examination, including gynecological examination and ultrasound, to determine the exact gestational age. Before the procedure, the doctor must make sure that the woman has no contraindications to the use of tablets. The patient is introduced to the principle of operation of drugs and the technique of abortion, she must clearly understand the features and side effects of the procedure. After that, a written agreement is signed for the manipulation.
main stage. First, a woman under the supervision of a doctor takes pills that cause rejection of the embryo and prepare the uterus for its expulsion. Within a few hours after the procedure, the woman is at the day hospital and, in the absence of side effects, is allowed to go home.
Completion. Accepted after 1.5-2 days next drug, which starts the process of expulsion of the fetal egg. Within two hours after taking the pills, the woman is under the supervision of a doctor.

Performance definition

36-48 hours after the procedure, the doctor does a control ultrasound, makes sure that there is no stagnation of blood in the uterus. After two weeks, it is necessary to undergo a second examination by a gynecologist and again do an ultrasound scan to make sure the procedure was successful and to exclude incomplete expulsion of the fetal egg from the uterus. In this case, the woman is assigned manual scraping.

Possibility of procedure failure

Each country sets its own deadlines for legal medical abortion, but you should understand that the higher the term at which the abortion is performed, the more likely it is that you will have to do a second purge. In the US, medical abortion is allowed up to 7 weeks, in Britain there are no such clear restrictions, there are different rules, in some cases, you can do up to 8 weeks, sometimes up to 9-13 and even up to 24 weeks.

In Russia, it is believed that medical abortion is best done before 6 weeks, sometimes up to 9 weeks, but most doctors do not want to take on such a responsibility. In their opinion, late medical abortion can cause serious side effects, such as bleeding or inflammation in the uterus caused by the remnants of the placenta. Therefore, on later dates additional cleaning is without fail. It turns out that what used to be a woman turns to a gynecologist, the higher the effectiveness of medical abortion, and the longer the term, the lower the effectiveness of the procedure and the greater the likelihood of complications.

At the first abortion, the risk of incomplete termination of pregnancy is higher. You can see this on the control ultrasound. With an increase in the gestational age, the possibility of maintaining a pregnancy increases, this can be tracked at a follow-up examination 1.5 - 2 weeks after the abortion. In general, studies show that partial removal of the ovum occurs in 3% -5% of cases, and pregnancy is maintained in no more than 1% of cases of the total number of medical abortions.

Contraindications and side effects

As with any medical procedure, complications can occur with medical abortion. They are quite rare, but every woman should know consequences of the procedure:

continuation of pregnancy. In 1%-2% of cases, abortion may not occur.
Strong.
Abundant uterine bleeding . May develop due to incomplete removal fertilized egg.
Fever, chills, weakness.
Nausea,. In such cases, the doctor may decide to re-use the medication.
Exacerbation of chronic diseases of the genitourinary system.
Hormonal disbalance.
Inflammation of the uterus and appendages. Sometimes it occurs due to the spread of infection from the urinary tract. At the same time, the temperature rises, the stomach hurts a lot, discharge appears.
Problems with uterine repair, for example, hematometra (blood in the uterus) or subinvolution in the uterus (delayed organ recovery). There are problems with the cycle, abdominal pain.
Prolonged bleeding, which can last up to 2 weeks, is associated with hormonal imbalance. Approximately 3% -5% of women after a pill abortion have a cycle disorder, with a conventional abortion, the percentage rises to 12% -15%. The reason for this phenomenon is considered to be neuroendocrine disorders due to a violation of the ability of the endometrium to recover. In women who have given birth, the cycle is restored within 4 months, in those who have not given birth - six months.

Exist certain contraindications for medical abortion, so the woman must first be examined by a gynecologist. Doctors note situations when a woman takes pills on her own, after which life-threatening complications arise. For example, it passes, just like normal, but in this case, medical abortion is contraindicated. Taking pills is fraught with rupture fallopian tube and death, or best case, infertility. Below highlight the main contraindications To medical abortion you should know about:

or suspicion of it.
Renal and adrenal insufficiency.
Diseases associated with impaired blood clotting.
Inflammatory processes of the genitourinary system.
Myoma of the uterus.
Long-term use of corticosteroids.

Failure to comply with contraindications often leads to unpredictable consequences and can be fatal, therefore, before starting the procedure, go through full examination see a qualified gynecologist and read information about medical abortion.

Negative consequences

On such early term The decision to terminate a pregnancy is made by the woman herself. As experience shows, the most common grounds for abortion are:

Before making a decision, think carefully about the consequences and about the life of the unborn baby. Pregnancy triggers certain mechanisms in a woman's body and completely changes the hormonal background. Artificial termination of pregnancy does not go unnoticed, it is a serious stress for the body, so the reverse restructuring of all processes can slow down or go away with complications that will have to be treated.

In most women, after an abortion, the cycle goes astray, menstruation is irregular and painful. Usually this is the first herald of what begins more serious problems. Another common complication is uterine bleeding. If it is not stopped in time, it can be fatal. Often in women there is a malfunction, the load on the adrenal glands increases, and this disrupts the metabolism. The production decreases, the amount of the male hormone increases, which stimulates the development of infertility and affects appearance women.

The breast almost immediately reacts to the occurrence of pregnancy, therefore, after an abortion, it suffers in the first place - the appearance of tumors and neoplasms is possible. Nulliparous women after an abortion are doubly at risk of developing infertility. Studies have shown that three out of ten women who have an abortion cannot subsequently have children.

The medical consequences of the procedure can be irreversible, so later, when the desire to have children appears, not everyone will be able to get pregnant - there is always a risk of developing secondary infertility. Any medical intervention, even the most seemingly harmless, can have side effects, even death. Therefore, do not joke with your health - it is preferable to carry out competent prevention of unwanted pregnancy, so that later you do not have to resolve the issue by drastic methods.

Modern medicine offers a wide variety of effective contraceptives that protect against unplanned pregnancy. But, as practice shows, not even one of the most reliable contraceptives will protect against unwanted pregnancy by 100%. Sometimes, pregnancy for a woman can become unpleasant and unexpected surprise. If pregnancy is not desired, then the only way find a way out of the current situation is to interrupt it. A few decades ago, the main method of birth control was abortion - curettage of the fetus from the uterine cavity by surgical intervention, and in the early stages, vacuum aspiration or mini-abortion was performed. This method of abortion is a danger to women's health and can lead to serious consequences in the future: bleeding, chronic inflammation, endometritis, miscarriage of subsequent pregnancies. To date, in gynecology, the most sparing and maximally safe method birth control - medical termination of pregnancy in the early stages.

Medical termination of pregnancy at an early stage (up to 4 weeks) artificially provokes a miscarriage, by taking drugs whose action is aimed at malnutrition of the fetus, which leads to its rejection from the uterine cavity, the procedure is carried out under the supervision of a doctor. To date, this method is the least traumatic way to get rid of unwanted pregnancy. After termination of pregnancy by this method, reproductive function woman is preserved, and in the future she can become pregnant and endure healthy baby. It also eliminates the risk of infection of the genital organs. infectious diseases and the consequences of the use of anesthesia, which is used in traditional abortion, are excluded.

Abortion pills

Non-surgical termination of pregnancy is carried out with the following drugs:

mifepristone.
Pencrofton.
Mifeprex.
Pencrofton.
Mytholian.
Miropriston.

Main Chemical substance that these drugs contain is called mifepristone. The dosage of the tablet is 200 mg. It is thanks to this substance that the detachment of the fetal egg from the uterine cavity occurs, which leads to its miscarriage. Mifepristone inhibits the uterine perception of pregnancy-preserving hormones.

Stages of medical abortion in early pregnancy

Gynecological examination in the clinic.
The first and important step before performing a non-surgical abortion is an examination by a gynecologist, who will conduct an examination, prescribe an ultrasound examination (ultrasound), which will make sure that the pregnancy is uterine and establish it. exact date. With a timely visit to the doctor, a woman is more likely to interrupt, completely safe for her health. unplanned pregnancy. Medical abortion is carried out before the period of 4 weeks of pregnancy (up to 42 days from the day of missed menstruation). For a period of 6 weeks or more, the medical method of terminating a pregnancy can lead to undesirable consequences- partial abortion, so the decision to have an abortion should not be delayed.
Clinics where non-surgical abortion is performed must be licensed to perform the procedure, it can be both public medical institutions and private ones. The task of the physician is to select the appropriate pharmacological preparation and acquaint the patient with the stages of the procedure and possible risks for her health.
In the absence of contraindications to termination of pregnancy, the gynecologist issues the dose of mifepristone necessary for the patient, which she must take under his supervision. It should be noted that the drug is taken on an empty stomach, so do not eat 2 hours before visiting the doctor. After taking mifepristone tablets, the patient should be in medical institution several hours, the reaction of the body to the drug may be different and cause side effects. The first sign that the process of embryo rejection has begun is the appearance spotting. The doctor sends the patient home and prescribes a second dose of the drug in 1-2 days. It is advisable to take the contact details of the doctor for emergency communication in case of possible complications. Approximately 60% of all medical abortions are successful at this stage. If an abortion does not occur after the prescribed period, prostaglandins are prescribed.

The third stage of non-surgical abortion occurs with the help of prostaglandins (synthetic excreted active substances that enhance uterine contraction). After taking them, the woman begins to bleed. The effect of the drug on each organism is individual, in some cases, women experience vomiting, diarrhea, dizziness, drawing pains resembling contractions, in which case the presence of a doctor is mandatory. A timely adjusted dose of the drug will reduce blood loss and eliminate possible side effects.
After a medical termination of pregnancy, a woman is obliged to visit a gynecologist in 10-14 days. The doctor will assess the condition of the uterus using ultrasound, examining the patient will make sure that there are no remnants of the fetal egg in her cavity, if the gynecologist's suspicions are confirmed, he will take measures to remove them. The recovery period of the body, as well as after surgery, lasts about a month. During this period, you must be extremely attentive to your condition, and with the slightest change in well-being, with the appearance of symptoms such as nausea, a sharp increase in temperature, with the appearance of bloody discharge, pain in the lower abdomen, urgently call a doctor or seek medical help.

During recovery period prohibited:

the use of alcoholic beverages;
live sexually (1-2 weeks);
visit the sauna, swimming pool;
physical exercise;
can not be supercooled;
use of tampons.

Contraindications for medical abortion

Unfortunately, there are some contraindications, in the presence of which women should not take drugs intended for abortion:

with a gestational age of more than 6 weeks;
in the presence of an ectopic pregnancy;
in the presence of intrauterine device in the uterine cavity;
for acute and chronic forms kidney or liver failure;
in the presence of inflammatory processes gastrointestinal tract; in the genitals of a woman, uterine myoma, scars in the uterine cavity;
with anemia, hypertension;
with long-term use of corticosteroid drugs;
with intolerance to mifeprestone;
also taking the drug is not recommended for lactation (it should be interrupted), and smoking women over the age of 35 years.

Consequences of medical abortion

After the procedure, the woman still has the effect of the pregnancy hormone progesterone on the body for a certain time. It can cause depression, which is accompanied by irritability, fatigue, insomnia, loss of appetite, and guilt from what you have done. Over time, these symptoms disappear and women return to their normal lives. But medical abortion is dangerous with other, more complex consequences:

Cases are not uncommon heavy bleeding after an abortion, so it is safer to take abortion drugs under the supervision of a doctor.
A woman may feel severe pain in the lower abdomen, as the drug affects the contraction of the uterus. There may also be pain in the intestines.
Abortion provokes inflammatory processes in the uterus, cervix, vagina, which lead to the development of vaginitis, cervicitis or endometriosis. In this case, immediate treatment should be carried out.
It can lead to an incomplete (partial) abortion, when a part or shell of the embryo remains in the uterus, in this case, women experience pain in the lower abdomen, they bleed. In this case, surgical intervention will be prescribed to remove the remnants of the embryo.

How to terminate an early pregnancy at home

Due to the possible consequences and complications and health risks, termination of pregnancy with pills should only be carried out under the supervision of a gynecologist. Many women are unaware of the risk to their health and try to terminate their pregnancy at home on their own. Such careless attitude to one's health is unacceptable. The only drug that is used at home within a day after intercourse is Postinor. It is advisable to take it in case of unprotected sexual intercourse, and the earlier a woman takes it, the more likely she is not to become pregnant. The action of the drug is aimed at suppressing ovulation and subsequent fertilization of the egg.

Pain after medical termination of pregnancy

In most cases, pain while taking a dose of mifepristone is tolerable, and pain reminiscent of pain, as during menstruation. But after taking a prostaglandin, a woman may experience severe cramping pain, as the drug contracts the muscles of the uterus, pushing the embryo out of it. With the unbearable severe pain painkillers are prescribed. If the pain does not stop after taking painkillers, you should inform your doctor.

Menstruation after medical termination of pregnancy

The restoration of menstruation occurs one cycle after a non-surgical abortion, the day of which is considered the first day of menstruation. Therefore, the countdown of the new cycle starts from the day of the procedure. Each organism recovers in its own way, and menstruation takes place in women in different ways, this process depends on the individual characteristics of the woman's body. For some, they are very plentiful, for others they pass like regular menstruation.

How to determine the date of the next menstruation

If the woman is healthy and the rejection of the embryo passed without complications, then the number of days that her normal cycle lasts is added to the date of the abortion. The date obtained during the calculation will be the number when the next menstruation should begin, but deviations from the calculation by several days are possible.

Factors that affect the recovery of menstruation

After medical intervention periods can be more painful and last for several cycles until the body comes to noma. Their recovery is influenced by factors such as:

chronic diseases and gynecological diseases of a woman;
hormonal failure in the body;
diseases of the thyroid or adrenal glands;
from what gestational age was when the abortion occurred;
the quality and dosage of the drug that was used for abortion.

It is worth noting that medical abortion, although considered the most reliable way, is not 100% effective. The drug taken is not always able to cause a miscarriage and this must be remembered. A delay in menstruation is a reason to contact a gynecologist to exclude the possibility of developing a progressive pregnancy. In this case, it is not recommended to conduct self-tests for pregnancy, as in female body failures have occurred, and the test will show an unreliable result. Only an ultrasound can confirm this fact. In addition, after a pharmacological abortion, a woman should take care of reliable method contraception to prevent re-conception. Therefore, if your period does not occur within the expected period, consult a doctor immediately.

ATTENTION!!! This article is for informational purposes only, do not self-medicate, consult a specialist.