Repeated medical termination of pregnancy. Medical abortion - termination of pregnancy without serious consequences? Cycle restoration, sex life, contraception and new pregnancy

Preserving a woman’s reproductive health involves gentle performance of all gynecological manipulations. This also applies to termination of pregnancy. It is known that the earlier the procedure is performed, 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 for a short gestation period.

What is a medication method?

Replacing the surgical instrument and vacuum aspirator with hormonal drugs made it possible to develop a method of pharmacological abortion. This is a non-invasive procedure for getting rid of pregnancy in the early stages, which occurs spontaneously.

Its advantages are associated with 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 primigravidas, the effect on women's health is minimal;
• low level of stress, does not create a traumatic situation.

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

Which is better, vacuum abortion or medical abortion?

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

How is the time for an abortion determined?

The timing for medical abortion is determined by the protocol of the Ministry of Health of the Russian Federation dated October 14, 21015. They record that it is possible to carry out a gestational disorder 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 period is defined as 49 days, or 7 weeks of pregnancy.

Why is such a period determined for pharmacological interruption?

At the 5th week of pregnancy, the embryo begins to acquire human features, the rudiments of many organs and the umbilical cord appear. At week 6, the placenta begins to form, and internal organs continue to develop. At week 8, the embryo already has a completely human appearance and enters the fetal stage. After this period, the formation of blood vessels in the placenta occurs, so a medical abortion can cause heavy bleeding.

The following drugs for medical abortion are registered and used in Russia:

1. Mifepristone 200 mg.
2. Misoprostol 200 mcg.

Pharmacological abortion can be used if the gestational age corresponds to that allowed by the 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 ultrasound results. After a caesarean section, the medical method is preferable to.

Preparation for the procedure

When you first visit a gynecologist, you need to conduct a general examination, a bimanual examination on a chair and in mirrors, and swabs are taken from the vagina. Blood pressure, pulse, and respiratory rate are also measured. Next, the woman is sent for an ultrasound to determine the exact day of gestation, the condition of the uterus, and the fertilized egg.

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

Execution method

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

For gestational age up to 63 days, 200 mg of Mifepristone is used, which the woman drinks with a doctor. A doctor's supervision is required for 1-2 hours, after which you can go home.

If the period is 49 days, 200 mcg of Misoprostol is taken at the next visit after 24-48 hours. 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. With the last method of administration, you need to lie down for 30 minutes. The patient should be observed for 3-4 hours. During this period, most people begin to bleed. If this does not happen, to achieve the result, take Misoprostol 400 mcg tablet again.

The signs of an abortion are identical to a spontaneous miscarriage. A woman feels a cramping stomach ache and menstrual-like discharge appears.

How long does the bleeding last?

For most women, it 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. As the period increases, the release of blood increases; sometimes the use of hemostatic therapy may be required.

After 14 days you need to appear for a follow-up examination. This is necessary to confirm that the interruption has occurred. If an unsuccessful medical abortion occurs, aspiration from the uterus is prescribed.

Contraindications

The above medications have serious side effects. Despite the high degree of safety, there are certain contraindications to medical abortion:

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

According to WHO recommendations, interruption using Mifepristone is possible up to 22 weeks, but the severity of bleeding increases parallel to the period. In this case, for the duration of the procedure, the patient is hospitalized in a hospital, where there is a large operating room and emergency surgical care can be provided.

Fibroids threaten the development of bleeding, but if the size of the largest node is up to 4 cm and they do not change the uterine cavity, then you can resort to a pharmacological method.

Anemia is also a relative contraindication. The consequences of medical abortion can manifest themselves in a decrease in hemoglobin concentration: bleeding after taking medications exceeds menstrual bleeding in volume and duration.

Disturbances in hemostasis have implications for the volume and duration of blood loss. If shortly before the procedure the woman was treated with anticoagulants, then an increase in blood clotting time will lead to more heavy bleeding. Women over 35 who smoke are at risk of developing thrombosis and cardiovascular diseases. Therefore, to exclude complications, a consultation with a therapist is carried out.

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

If pregnancy occurs while an IUD is installed, 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 contribute to the development of ascending infection, and treatment of acute infection can be carried out simultaneously.

Mifepristone and Misoprostol pass into breast milk. If there is a need for interruption during breastfeeding, then you need to express milk for up to 5 days after taking Misoprostol. During this time, the child is transferred to artificial feeding.

Bronchial asthma, high blood pressure and glaucoma are diseases that respond to prostaglandins. Therefore, in these pathologies, taking Misoprostol is contraindicated.

In addition, the contraindications for each drug should be taken into account. For the most part they coincide with those given above. It can only be supplemented with careful use of Misoprostol in patients with epilepsy, cerebral atherosclerosis, and coronary heart disease.

Possible complications

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

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

• severe pain syndrome;
• heavy bleeding;
• temperature;
• incomplete abortion;
• progressive pregnancy.

Pain in the lower abdomen is observed during the period of expulsion of abortion products. Its intensity may vary, but the individual tolerance threshold also matters. Analgin and Drotaverine are used to reduce pain. WHO recommendations indicate Ibuprofen to reduce pain. If your breasts hurt after an abortion, this may be due to high levels, which increase as pregnancy progresses. This symptom goes away on its own.

Bleeding is considered significant if you have to change two pads in an hour, and this condition lasts 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, medical abortion is incomplete. Then it is also necessary to perform vacuum aspiration or curettage of the uterine cavity. Less than 1% of cases result in pregnancy progression. If a woman insists on an abortion, then invasive methods are used. Those who have changed their decision must be informed about the possible teratogenic effect of the drugs on the fetus. But there is not enough data to confirm this fact.

Taking medications may cause a slight increase in temperature, but this lasts no more than 2 hours. If the fever lasts for 4 hours or more or occurs one day after taking Misoprostol, this indicates the development of an infectious process. A woman with these symptoms should consult 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 with;
• women with a large number of sexual partners or low socioeconomic status.

Other complications in the form of dyspeptic symptoms may be a sign of pregnancy itself. For allergic reactions, treatment with antihistamines is necessary.

Recovery period

After taking Mifepristone and Misoprostol, there is no disruption of the menstrual cycle. But when menstruation begins and how long it lasts after a medical abortion is difficult to predict. The timing of the procedure matters; after an earlier interruption, the cycle is restored faster.

The first menstruation may begin in 30-50 days. But medical abortion does not affect the onset, so a new fertilization is possible in the first cycle. To avoid this, immediately after the procedure the doctor prescribes combined oral contraceptives. These may be such means as Yarina, Regulon, Rigevidon, Novinet, Lindnet, Jess. The selection of a medicine occurs individually.

Protects against unwanted pregnancy in 99% of cases. The positive effect is the regulation and restoration of the menstrual cycle. The minimum period for such contraception is 3 months, but you need to wait until the body fully recovers to decide when you can get pregnant. Usually this is a period of at least 6 months.

If pregnancy occurs earlier, this can lead to complications such as:

• threat of interruption;
• ectopic pregnancy;
• anemia in a woman.

Doctors' advice 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, or swim in open water;
• do not take a hot bath, take a shower instead;
• take care of your health, during the cold season, 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;
• At first, physical activity should be limited. Those who are intensely involved in sports or fitness should stop going to the gym for a while;
• will limit stressful situations and emotional overstrain.

Sexual activity after a medical abortion is possible after the end of the first menstruation. The uterus after an artificial miscarriage is an extensive wound surface with a breeding ground for microorganisms. Sexual contact always carries a risk of infection. In addition, active frictions can cause discomfort or lead to resumption of 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 menstrual cycle does not resume within 2 months, you should consult a doctor to conduct an examination and look for the causes of hormonal imbalance. You may also be concerned about discomfort in the mammary glands, which have begun to prepare for lactation. Therefore, in some cases, a consultation with a mammologist is recommended.

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

Medical termination of pregnancy is a modern and safe method. Although this procedure does not require surgical intervention, it is very important to know how it goes and what complications can occur, what the rehabilitation period looks like after taking medications.

What is a medication method?

It is a non-invasive procedure for early pregnancy termination - similar to a spontaneous miscarriage. Has the following advantages:

• efficiency - 95%;
• no risk of injury to the uterus during surgical procedures;
• low risk of infection;
• there is no danger of “earning” hepatitis or HIV, which can happen during surgery;
• there are no health risks associated with anesthesia;
• the impact on the female body is minimal, so such manipulations can be carried out even during the first pregnancy;
• low level of stress, which prevents the creation of traumatic situations that can harm the female body.

This procedure does not require a hospital stay for a long time; after taking medications, you can go home. However, it is worth remembering that only a specialist can prescribe medications.

Since this method of abortion is quite new, many still resort to vacuum abortion, but it is worth remembering that in this case the degree of intervention in the body and the risk of complications will be higher.

Timing of medical abortion

The timing is determined by the protocol of the Ministry of Health of the Russian Federation dated October 14, 2015, which states that drug intervention can be carried out until the ninth week of pregnancy. However, in most European countries the maximum period is 7 weeks.

Why are these particular deadlines determined? It is worth noting that in the fifth week of pregnancy, the embryo begins to develop human features and the formation of organs and the umbilical cord begins. By the sixth week, the placenta has already formed and the organs continue to develop. At the eighth week, the fetus has a human appearance, during this period the blood vessels of the placenta are formed, and for this reason, taking medications during this period can cause severe bleeding.

In Russia, for medical termination of pregnancy, the following pills are used:

The average cost of the procedure is from 15,000 rubles, depending on the clinic.

Are there any contraindications

This procedure also has a number of contraindications. For example, you should not take drugs from this group in the following cases:

• if the pregnancy is more than 6 weeks;
• with ectopic pregnancy;
• in acute forms of renal and liver failure;
• in the presence of inflammatory processes in the gastrointestinal tract;
• in the presence of fibroids;
• after long-term use of corticosteroid drugs;
• in case of intolerance to Mifeprestone.

• during lactation - in this case it must be interrupted for at least two weeks;
• women over 35 years old;
• if there are scars on the uterus after surgery.

Permission to carry out a medical abortion can only be given by the attending physician after a thorough examination of the patient.

How is the abortion procedure performed?

If a woman decides to terminate her pregnancy, she first goes to her gynecologist, who conducts diagnostics to confirm the pregnancy, sets the date and contraindications. Also at this stage, the doctor may recommend a medical termination in case of abnormalities in the development of the fetus: if pathologies are detected or if the mother feels such that she cannot bear the child.

If there are no contraindications to childbirth, but the woman still does not want to give birth, she is given a short amount of time to think. If the woman nevertheless decides to terminate the pregnancy, the doctor determines whether there are contraindications to this procedure.

Medical termination of pregnancy consists of several stages.

Stage one

A woman takes 3 tablets (dosage: 600 mg). Moreover, throughout the entire stage the patient must be under the close supervision of a specialist.

The duration of the stage depends on the body's response to the drug.

Ideally, it lasts no more than six hours: during this period, the woman may feel pain in the lower abdomen, and spotting may appear - this is a normal reaction to the drug, since the process of rejection of the fertilized egg occurs.

After successful completion of the drug, the woman is prepared for the second stage of the procedure.

Second phase

It begins 1.5-2 days after taking the pills. Moreover, it is not necessary to go to the doctor: if you feel normal, it is enough to take the pills at home. It is important to remember that in the second stage there may be more bleeding and pain, so it is worth taking a day off from work. If the pain is too severe, you can take painkillers.

An important point: you need to buy only certified medicines, since the life and health of a woman depends on it.

Actions after taking the pills

A few days after taking the medication, you need to contact a gynecologist: the doctor will examine you, check whether the medicine has worked, whether there are any remnants of the fertilized egg left in the body, or whether rejection has occurred. To avoid unpleasant consequences, it is necessary to undergo a control ultrasound.

If egg remains are found in the uterus, the doctor prescribes further treatment.

After 1.5-2 weeks, they are examined again and an ultrasound is prescribed. If the ultrasound does not give results, the doctor may order a blood test to determine the level of hCG.

It is important to remember that when performing a medical abortion in the early stages, the success rate of the procedure is more than 95%, but if you apply later, there is a high probability of an incomplete abortion, as a result of which a vacuum will have to be performed.

After completing the activities, you should adhere to several important rules:

1. Use contraceptives during sexual intercourse, since a new pregnancy can occur even before the start of menstruation. Moreover, it is undesirable to have sex earlier than 2-3 weeks later.
2. You should refrain from drinking alcohol.
3. Avoid visiting saunas and baths.

What could be the consequences?

With such an abortion, complications usually occur in no more than 3-5% of cases, but they still happen. You need to be able to differentiate between the two, as there are mild complications, such as minor abdominal pain and occasional bleeding, and serious problems that require you to see a doctor.

For example, slight pain, fever that lasts for several hours after diagnosis, chest pain - this is a normal reaction of the body to a medical abortion. You need to take a pain reliever, such as Analgin or Ibuprofen.

But if the high temperature does not decrease for six hours or more, this may indicate an infectious process. In this case, you need to urgently consult a doctor.

Although infectious complications are not typical for this form of abortion, there is a group of people who are at greater risk than others:

• those diagnosed with bacterial vaginosis, chlamydia;
• patients who had a sexually transmitted infection less than a year ago, but there is no confirmation of complete cure.

Recovery after abortion

After taking the pills, the menstrual cycle is not disrupted, but it is quite difficult to predict when they will start again - the timing of the procedure also matters here (in the early stages the cycle is restored faster).

The first period can start in 1-2 months, but a lot also depends on the patient’s condition. If your period has not started after 60 days, you should definitely consult a gynecologist for advice.

Despite its effectiveness and minimal complications, medical abortion is not an ideal solution, since any intervention in a person’s internal environment can have consequences. To avoid them, you should think about contraception and family planning in advance.

Why does it occur, at what time does a pipe burst? Read more about this in our material.

This method is used in the early stages of pregnancy, up to 49 days late from the first day of the last menstruation.

The following drugs are currently used:

• Mifegin (made in France);
• Mifepristone (made in Russia);
• Pencrofton (made in Russia);
• Mifolian (made in China).

The mechanism of action of all drugs is the same. The receptors for the hormone progesterone, which is designed to support the pregnancy process in the body, are blocked, and as a result, the embryonic membranes are detached from the uterine wall and the fertilized egg is expelled.

All these drugs cannot be bought in pharmacies without an appropriate prescription!

Stages of implementation

Before undergoing the procedure, make sure that the doctor has all the necessary documents and permissions.

Many women wonder how painful is the procedure.

Usually the pain is a little worse than during normal menstruation. You will feel a cramping pulsation of the uterus. In consultation with your doctor, you can take a pain reliever.

• After a medical abortion it is necessary abstain from sex for 2-3 weeks: it may well cause bleeding and inflammation. In addition, one of the complications may be a change in ovulation, and a woman may well become pregnant 11-12 days after the procedure;

• Menstruation usually starts within 1-2 months, but disruptions to the menstrual cycle are possible.

• Pregnancy can be planned after 3 months, if everything went well. Before planning, you must see a doctor.

Contraindications and possible consequences

Tablets are potent drugs that have a number of contraindications:

• age over 35 and under 18 years;
• within three months before conception, hormonal contraceptives (oral contraceptives) were taken or an intrauterine device was used;
• suspected ectopic pregnancy;
• pregnancy was preceded by an irregular menstrual cycle;
• diseases of the female genital area (fibrous tumors, endometriosis);
• hemorrhagic pathologies (anemia, hemophilia);
• allergies, epilepsy or adrenal insufficiency
• long-term use of cortisone or similar drugs;
• recent use of steroids or anti-inflammatory drugs;
• renal or liver failure;
• inflammatory diseases of the gastrointestinal tract (colitis, gastritis);
• bronchial asthma and other pulmonary diseases;
• pathologies of the heart and blood vessels, as well as the presence of cardiovascular risks (high blood pressure, obesity, smoking, diabetes);
• allergic reaction or hypersensitivity to mifepristone.

Quite often, after a medical abortion, hormonal imbalances begin, causing various gynecological diseases (inflammation, endometriosis, cervical erosion, fibroids). All this can subsequently lead to infertility.

Is the safety of velvet abortion a myth or reality?

As we can see, at first glance, this is a fairly simple operation, and most importantly, as they say, it is largely safe compared to surgical intervention. However, in reality, not everything is as simple as it seems.

Is this “security” safe?

• If the procedure is not carried out on time(after 7 weeks of pregnancy), then even death is quite possible. Although there are dozens of proven cases of death from mifepristone in the European Union alone, in reality, experts agree, there are many more of them, and there are thousands of those who suffered irreparable damage to health. Dr. Randy O'Bannon, director of research for the National Pro-Life Committee (USA), said it is very difficult to obtain information about the death of a patient as a result of taking the drug. This information flows to the manufacturer and immediately becomes inaccessible to people.

We must not forget that abortion, whether pharmacological or surgical, is the murder of the unborn child.

If you find yourself in a difficult life situation and want to have an abortion, call 8-800-200-05-07 (helpline, call from any region is free).

Reviews:

Svetlana:

I went to an antenatal clinic on a paid basis. First, I had an ultrasound, determined the gestational age, then took a smear for infections, made sure there were no infections, and gave the go-ahead. My deadline was 3-4 weeks. I took three tablets of mefepristone. They can be chewed, not bitter. At first I felt a little nauseous, but the nausea went away after I drank kefir. Before they sent me home, they explained everything to me, and also gave me instructions and 4 Mirolut tablets. They told me to take two in 48 hours, if it didn’t work another two in two hours. I took two tablets on Wednesday at 12:00 o'clock, because... nothing happened - I drank another one. After this, blood began to flow, profusely with clots. My stomach hurt, as if I had menstruation. For two days the blood flowed profusely, and then it just smeared. On the seventh day, the doctor said to start taking Regulon to restore the menstrual cycle. On the day of taking the first pill I stopped. On the tenth day I did an ultrasound. Everything is okay.

Varya:

I was forbidden to give birth for some reason, so I had a medical abortion. Everything went without complications for me, but with such pain that mom, don’t worry!!! I took 3 tablets of no-shpa at a time to make it at least a little easier... psychologically it was very difficult. Now I’ve calmed down, and the doctor said that everything went well.

Elena:

The doctor advised me to have a medical termination of pregnancy, underwent an examination, took mifepristone tablets, and then sat for 2 hours under the supervision of a doctor. She came 2 days later, they gave me two more tablets under the tongue. An hour later there was blood and discharge, my stomach hurt terribly, so I climbed onto the wall. Clots came out. And so my period lasted 19 days. I went to the doctor, they did an ultrasound, and they found the remains of the fertilized egg. As a result, they also gave me a vacuum!!!

Daria:

Good afternoon everyone! I am 27 years old, I have a son, he is 6 years old. At the age of 22, I gave birth to my son, when he was 2 years old, I became pregnant again, but they didn’t want to continue the pregnancy, because the little one was very restless and I was simply tortured. I made honey. Abortion! Everything went without problems! After 2 years I became pregnant again and did it again. Everything went fine again. Well, time passed and I stopped again with pills. And the nightmare begins! I took the pills that the doctor prescribed, at home, it was very bad, there was heavy discharge! Gaskets didn't help! In general, horror. Long story short, the girls sent me to a vacuum... Two previous medical appointments. abortion. They weren’t painful, everything turned out without any problems! But 3 of course terrified me! To be honest, I regret it…..Now I’m taking antibiotics…

Natalia:

Apparently everyone has their own way. My girlfriend did it. She said it was as if her period had started, no pain, no complications, just nausea...

If you need advice or support, go to the page (https://www..html) and find out the helpline or address of the Maternity Support Center closest to you.

The site administration is against abortion and does not promote it. This article is provided for information only.

Comments

Medical abortion, otherwise pharmaceutical or “velvet” abortion, is a method of terminating pregnancy in its early stages using special drugs that does not require surgical intervention.

Advantages of medical abortion:

• Does not require surgical intervention;
• Produced in the early stages of pregnancy, when significant hormonal changes have not yet occurred;
• It is the least traumatic, since the cervix and mucous membrane of the uterus are not subjected to mechanical stress, due to which they remain intact;
• It does not have such severe consequences as others, and significantly reduces the risk of infertility in the future.
• There is no need for anesthesia, so this type of abortion is suitable for women for whom anesthesia is contraindicated;
• Menstrual function is restored within 28-30 days.

Description of the method

Pharmaceutical abortion is a single dose of a drug with the active ingredient mifepristone. Mifepristone blocks the action of the hormone progesterone, which stimulates the growth of the endometrium, resulting in the detachment of the embryo from the walls of the uterus. At the second stage, a drug is taken - an analogue of prostaglandins (the active substance is misoprostol), under the influence of which the muscles of the uterus begin to contract and the fertilized egg is pushed out of its cavity. Thus, a medical abortion is an induced miscarriage. According to statistics, its effectiveness is 95-98%.

Preparations:

Antigestagenic drugs(containing mifepristone 200 mg):

• Mifegin (France);
• Mifepristone (Russia);
• Pencrofton (Russia);
• Mifolian (China).

Prostaglandin preparations(containing misoprostol):

• Misoprostol (Russia);
• Mirolyut (Russia);
• Cytotech (UK).

These drugs are not sold in pharmacies without a prescription. The quality of the drugs used often depends on the country of origin (French tablets are considered the best). Medical abortion can only be performed under the supervision of a highly qualified physician in a medical facility. Before the procedure, it is recommended to find out what drug will be used and check the clinic’s license to permit this type of activity. Carrying out a medical abortion at home is unacceptable.

• From the very beginning of its development, humanity has tried to control birth rates and looked for ways to prevent unwanted pregnancies. you will find information about modern contraceptives.
• Emergency contraception methods are recommended only when it is necessary to prevent an unwanted pregnancy after unprotected intercourse or failure of other methods of birth control. These methods of contraception are described.
• Today, intrauterine contraception is very popular among women. Statistics show that more than seventy percent of women successfully use contraceptives.

Medical abortion can only be done in the early stages - up to 42 days from the first day of the last menstrual period (or up to 49 days after the end of the last menstrual period). Abortion is most effective up to four weeks, while the fertilized egg is still weakly attached to the wall of the uterus and hormonal changes in the body are insignificant. In the future, the effectiveness of the procedure is greatly reduced and the risk of possible complications increases sharply.

Stages of medical abortion

Preliminary inspection

A gynecologist diagnoses pregnancy and sets its exact date. It is necessary to exclude ectopic pregnancy (in case of which medical abortion is unacceptable) and the presence of contraindications.

First stage

The patient takes mifepristone 600 mg (3 tablets) in the presence of a doctor and remains under his supervision for 2 hours. She then receives recommendations and medications for the second stage of abortion. At the first stage, cramps in the lower abdomen may occur and spotting may appear, which is normal. It is better to do a medical abortion no earlier than 2 hours after the last meal.

Second phase

36-48 hours after taking mifepristone, the patient should independently take the prostaglandin preparation given by the doctor. It is advisable to stay at home throughout the day. The degree of pain and the amount of bleeding depend on individual characteristics. It is important to follow all doctor's recommendations and take only approved pain medications as needed.

Control examinations

3 days after taking mifepristone, the patient should undergo a gynecological examination and the first control ultrasound, and after 7-14 days a repeat examination and ultrasound control. If necessary, an hCG test is taken to confirm the abortion. In case of incomplete abortion, vacuum aspiration or curettage is performed.

Contraindications for medical abortion

• Ectopic pregnancy;
• Inflammatory gynecological diseases;
• Uterine fibroids;
• Inflammatory diseases of the gastrointestinal tract;
• Acute or chronic renal or liver failure;
• Pregnancy resulting from the use of;
• Anemia and bleeding disorders;
• Individual intolerance to mifepristone;
• Taking corticosteroid drugs and anticoagulants.

Restrictions:

• Smoking over 35 years of age;
• Postoperative scars on the uterus;
• Hypertension;
• Lactation (you must stop breastfeeding for 14 days).

Possible complications after an abortion

Even if all instructions are followed, an unfavorable outcome from a medical abortion cannot be ruled out.

• Continuation of pregnancy or incomplete abortion;
• Uterine bleeding requiring medical intervention;
• Abdominal pain;
• Nausea, vomiting;
• Weakness, dizziness;
• High blood pressure, migraine;
• Increased body temperature;
• Allergic reactions (rare).

You should abstain from sex for two to three weeks so as not to provoke bleeding and the development of inflammatory processes. One of the consequences of an abortion may be a change in ovulation, and, as a result, a woman runs the risk of becoming pregnant 11-12 days after the procedure. Therefore, immediately after an abortion you need to start using contraception. If the outcome is successful, you can plan a pregnancy after 3 months.

There are no significant delays after this procedure. In most cases, the first menstruation after an abortion begins after the number of days that constitutes the normal cycle for a given woman, if the first day of the previous menstruation is considered to be the day of the abortion or the time of the onset of bleeding that occurs within 24 hours after taking the drug. The rapid restoration of the cycle is explained by the absence of mechanical damage to the uterus and hormonal disruptions.

For several months after an abortion, deviations in the direction of increasing the duration of the menstrual cycle are allowed; the delay can be up to 10 days.

Natalia:

I am 31 years old, I have two children, I had a medical termination of pregnancy for medical reasons at 6 weeks. I want to say the main thing: everyone has a different body and different tolerance. Everything went fine for me, I'm happy with the result. The doctor warned against taking aspirin and thermal treatments (sauna, hot bath, etc.), as this could cause severe bleeding. I strongly advise everyone to stay at home while taking the pills, preferably under the supervision of relatives, as severe dizziness occurs, almost to the point of loss of consciousness.

Arina:

I am 24 years old. I'll get straight to the point. Ultrasound showed a period of 3-4 weeks. After taking the first three tablets, I felt slightly nauseous and had general weakness. After the remaining pills, it was pouring out of me so much that due to the enormous loss of blood, I was moving along the wall from the sofa to the toilet. At the same time, clots the size of a small chicken (!!!) egg came out. This lasted from 5 to 9 pm. The vegetable’s condition lasted for about five days; I constantly wanted to lie down and felt dizzy. The discharge continued for about 2 weeks. After this nightmare, I want to say - between vacuum aspiration and medical abortion, choose a vacuum, I did that too. So, in this case, you came to the clinic, suffered for 3 minutes and went home, you don’t have to walk around like a vegetable for a week, not knowing whether everything went well or whether they’ll send you for cleaning.

Anna:

I had a pharmaceutical abortion twice, for up to 6 weeks, using Russian drugs in a private clinic. Everything was fine, no heavy bleeding, no severe pain. The doctor said that such an abortion cannot always be performed on nulliparous women. I wish everyone to take better precautions, it’s still a little difficult mentally.

The consequences of medical termination of pregnancy are less dangerous than surgical ones, but in the absence of qualified assistance they can lead to infertility and even death. Taking pills is not difficult, however, despite the apparent simplicity of the procedure, it causes serious changes in the body: a large dose of hormones affects the reproductive system and disrupts the natural processes of preparation for bearing a fetus.

Vomit

This complication develops in approximately 44% of women when taking misoprostol orally, and in 31% when taking intravaginal misoprostol. Studies also confirm that the frequency of vomiting is influenced by the interval between taking a hormonal drug (Mifepristone) and a prostaglandin (Misoprostol). The likelihood of this symptom is lower if the interval is 7-8 hours than with a daily break.

Nausea

This symptom is more common than other gastrointestinal disorders during medical abortion. It has not been fully established what exactly it is caused by: exposure to drugs or termination of pregnancy.

However, a trend has been identified in which nausea is more pronounced with a high dose of Misoprostol (a prostaglandin), rapid administration and a gestational age of 6-7 weeks. If vomiting occurs, you must inform your doctor. You may need to take the pills again.

Allergy

Allergic reactions as a consequence of medical abortion can develop to the components of any of the drugs taken. Most often it is a rash or hives. Severe manifestations, such as Quincke's edema and breathing problems, occur extremely rarely. To avoid this complication, after taking medications you should stay in a medical facility (clinic) for at least a few hours.

Diarrhea

Stool disorders develop in approximately 36% of women when taking Misoprostol orally and in 18% when taking Misoprostol intravaginally. The symptom can have varying degrees of severity. The effectiveness of taking antidiarrheals in such cases has not been proven. Diarrhea usually stops on its own after a few hours.

Severe abdominal pain

This symptom is caused by spasm of the muscles of the uterus, which is part of the mechanism of action of the hormonal drug. It is observed in 96% of women and is considered normal. The severity of pain can vary: from mild to unbearable. The symptom begins to increase rapidly 30-50 minutes after taking Misoprostol and most often goes away after the abortion is completed. There is a tendency that the shorter the pregnancy, the easier the pain.

To eliminate it, non-steroidal anti-inflammatory drugs (Ibuprofen, Naproxen) are used, and in severe cases, narcotic painkillers (Codeine, Oxycodone).

Convulsions

Appear approximately 1.5-3 hours after taking Misoprostol. Most often localized in the groin area. They subside after the abortion is completed. A warm heating pad can be used to reduce pain.

All of the above complications do not require special treatment and most often go away on their own after the abortion is completed. When they are severe, symptomatic remedies are used.

Medium-term consequences and complications

Medium-term effects occur within a few weeks of medical abortion.

Bleeding

This symptom appears early, some time after taking the pills. If the bleeding volume corresponds to menstrual bleeding (no more than 1-2 pads per hour), lasts 7-14 days and gradually decreases, then there is no cause for concern - this is not a complication, but a normal process.

In some cases, women notice discharge for up to 30 days, but it is spotting and is not accompanied by pain or other symptoms. If the bleeding is heavy (2-3 or more pads per hour), prolonged and/or accompanied by pain, then you must immediately inform your doctor. This complication is rare and develops against the background of incomplete abortion or infection.

The longer the pregnancy, the higher the risk of abnormal bleeding. In 0.4% of cases, blood transfusion is performed, in 2.6% - suction curettage. Without timely medical assistance, death cannot be ruled out.

Continuing pregnancy or incomplete termination

In 1-4% of cases, the fertilized egg is not expelled from the uterus or is not completely expelled. This can happen for several reasons: the dose of the drug is incorrectly calculated, the timing of the procedure is too late, there are hormonal disorders or inflammatory processes in the woman’s body.

Such consequences after medical termination of pregnancy are accompanied by prolonged and undiminished bleeding, nagging or cramping pain in the lower abdomen, increased temperature, and fever. You cannot cope with them on your own; hemostatic drugs will not help.

An ultrasound and follow-up are required. If this is not done, then in the event of an incomplete abortion, the remnants of the fetal egg will lead to the spread of infection, general blood poisoning and death. If the pregnancy continues to develop, then the risk of having a child with serious malformations is high.

Pain in the lower abdomen

Normally, cramps in the uterus gradually disappear after the abortion is completed. If the pain continues, this may be a sign of infection or incomplete termination of pregnancy. This symptom requires examination by a gynecologist and ultrasound.

Headaches and dizziness

These consequences of medical abortion develop in 20% of women. As a rule, the cause is a large loss of blood. Weakness, decreased blood pressure, and lightheadedness are also observed.

If dizziness is accompanied by bleeding, then the help of a doctor is necessary. In another case, you can take an analgesic, rest more often, and change your body position gradually.

Long-term effects and complications

Long-term consequences of medical abortion are rare but most difficult to treat. They appear after several months and even years.

Menstrual irregularities

If menstruation began on time (counting from the date of abortion) or was delayed by 7-10 days, this is a sign that the reproductive and endocrine systems have recovered. About 10-15% of women note that in the first few cycles, menstruation is more painful and heavy, but soon becomes the same as before.

A complication will be indicated by a delay of more than 40 days or heavy periods, accompanied by cramping intense pain, fever, and deterioration in general well-being.

In the first case, either a re-occurrence of pregnancy is possible (this happens already 2 weeks after an abortion), or a disruption in the functioning of the ovaries. It is necessary to consult a doctor, he will determine the cause and prescribe the necessary procedures. Oral contraceptives are often used to restore hormonal levels.

If your periods are very heavy, with severe pain and a rise in temperature, then perhaps particles of the fertilized egg remain in the uterus and/or an infection has developed.

After a doctor’s examination and ultrasound, curettage is performed and antibiotics are prescribed.

Infectious and inflammatory diseases

They develop after a medical abortion as an exacerbation of chronic forms or due to remaining particles of the fertilized egg. If a woman had hidden, sluggish infectious and inflammatory processes (salpingitis, gonorrhea, etc.) before the abortion, then after the abortion procedure they may begin to progress.

This is manifested by pain in the lower abdomen, discharge with an unpleasant odor and a greenish color, purulent impurities, and increased temperature. After laboratory diagnosis, the doctor prescribes antibiotics, most often in a hospital setting.

Infertility

The causes of this serious consequence are hormonal disorders or inflammatory diseases of the uterus and appendages.

In the first case, the balance of male and female sex hormones is disrupted, as a result of which the process of fertilization of the egg and its attachment to the wall of the uterus is hampered.

Inflammatory processes can lead to the formation of adhesions and narrowing of the lumen of the fallopian tubes. This prevents the egg from moving to the uterus.

Changes in emotional state, character

Sometimes hormonal imbalance and the abortion procedure itself affect the characteristics of a woman’s psyche. She may become overly irritable, aggressive or whiny, depressed, lethargic.

At first, such reactions are observed only in difficult situations, for example, during or after a quarrel. But soon they become total, arising without external causes.

To eliminate the problem, you need to see a doctor: a psychiatrist or psychotherapist, or consult a psychologist.

Medical abortion and its consequences are still being studied. Research confirms that the earlier the abortion procedure is performed, the lower the risk of complications.

The most common among them are bleeding, pain in the lower abdomen, and infection. The consequences are associated with hormonal disorders and the risk of incomplete release of the fertilized egg. Disruptions in the menstrual cycle, development of inflammation, and infertility may occur.

Useful video about medical abortion

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