How long is the medical termination of pregnancy. Medical abortion: all about abortion pills

Medical abortion pills are designed to end a pregnancy at early dates up to 12 weeks from the last menstrual period. The less time has passed since conception, the easier it will be for medical abortion and the less consequences the procedure will leave.

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What is a medical abortion? How to reduce risks?

Medical termination of pregnancy is an artificial abortion without surgical intervention. In this case, drugs are used that stop the vital activity of the embryo and expel the fetal egg.

Tablets are produced with a different composition of the active substance and a different principle of exposure to the body. Therefore, it is impossible to independently select such funds - this is done by a gynecologist. The doctor focuses on the timing of pregnancy, the age and weight of the patient, the number of previous pregnancies, a history of miscarriages, contraindications, etc.

Deciding to have an abortion, not even associated with surgical intervention, a woman must understand that the use of pills that cause miscarriage, and this is exactly how medical abortion occurs, is stress for the body. But in the case of properly selected medicines, there will be no big health problems in the future. The only way to reduce the risks is to consult a good doctor and strictly follow his instructions.

Types of pills for medical abortion

Depending on the duration of pregnancy, there are various medications that provoke an artificial miscarriage. They are divided into three groups:

1. Applied within two days after unprotected intercourse(Postinor, Escapel). The effectiveness of the drug is 95% if taken within 24 hours after sexual contact. The drug ceases to act after 72 hours (3 days), so the medication is intended exclusively for emergency termination of pregnancy.
2. Early abortion drugs(up to 42 days from the date of the last menstruation). They can be used both as emergency contraception and to terminate an existing pregnancy (Mifegin, Mifolian, Genale). This option is the safest and gives the maximum interrupt guarantee.
3. Antiprogestogenic drugs for medical abortion 42 to 62 days from last menstrual period (Mifepristone, Misoprostol, Pencrofton). Russian doctors try not to perform a medical abortion after 42 days of pregnancy, as they believe that the procedure will cause great harm to the body, because the patient has to take a large dose of medication. In addition, the percentage of interruption effectiveness is reduced. This is due to the fact that over long periods of abortion takes place in conditions of reliable attachment of the embryo to the wall of the uterus.

Miscarriage medications contain antiprogestogens that block the production of the female sex hormone progestogens. The drugs are not sold in pharmacies and are used only in a hospital where the gynecologist can control the expulsion of the embryo from . The longer a woman's pregnancy, the lower the chance of an abortion. At week 7, the efficiency drops to 93%, at week 8 - to 88%.

Medical termination of pregnancy by European standards is permissible up to 12 weeks. But even there, for a period of more than 6 weeks, it is carried out only in medical institutions due to severe bleeding caused by detachment of the endometrium. Therefore, to the question: “How long is an abortion with pills?”, You can answer that in Russia the procedure is done up to 6-7 weeks.

How are abortion pills different?

The general principle of the action of medications for abortion is based on changes in the hormonal background characteristic of the pregnancy period. As a result, the embryo is rejected and expelled from the uterine cavity. Differences in drugs are based on the active substance acting on the fertilized egg.

Based on this, drugs are divided into two groups:

1. Antagonists (opposite) of progesterone(Mifegin, Mifepristone, Genale). Progesterone is a steroid (physiologically active, powerful and versatile) sex hormone produced by a woman's ovaries in large quantities during pregnancy. It helps prepare the body for conception: it makes the endometrium softer, relaxes the muscles of the uterus, reduces immunity so that the female body does not reject the male egg. Progesterone antagonists are artificial and natural: synthetic - progestin (progestogen), natural - progesterone.
2. Prostaglandins(Misoprostol, Dinoprost). It's physiological stimulating active ingredients embryo rejection process. They act on the smooth muscles of the uterus, provoking its contractions. Used to terminate pregnancy at 16 to 23 weeks.

Characteristics of drugs for abortion

What means for medical abortion are used in Russia and the CIS countries

Consider several drugs that are officially approved in Russia and neighboring countries.

Postinor

Postinor -means of emergency contraception No. 1 in the post-Soviet space. On the territory of the CIS, a drug produced by the Hungarian company Richter Gedeon is allowed.

This is a very powerful tool that has many side effects. It simultaneously affects the menstrual cycle and the structure of the uterus. Postinor does not have a direct abortive effect, but only prevents pregnancy itself after unprotected intercourse, so taking it later than 2 days after conception is useless and dangerous.

How to use. Postinor is taken as follows: it consists of two tablets, each of which contains 750 mcg of levonorgestrel (a synthetic progestogen that inhibits the production of sex hormones by the pituitary gland). The first tablet should be drunk the next morning after a stormy night, maximum - on the evening of the third day (until the division of germ cells has occurred and the embryo has begun to form). After 12 hours, you need to take the second pill, otherwise there is no point in taking Postinor.

The principle of operation of Postinor. Synthetic progestogen inhibits the maturation of the follicle, thereby shifting the monthly cycle. Cervical mucus also thickens, preventing the penetration of sperm into the uterine cavity. The structure of the endometrium changes, it becomes looser and thicker, preventing the fertilized egg from attaching to the uterine wall.

Advantages and disadvantages

• pros. Despite the great risk to a woman's health, Postinor has an important positive aspect. If, nevertheless, pregnancy has occurred (due to improper pill intake, vomiting after use, another sexual intercourse after using Postinor for the first time), then negative impact the pill will not affect the development of the embryo, unlike some other drugs for emergency termination of pregnancy.
• Minuses.Postinor has a lot of contraindications. This method is suitable only for healthy women with a regular menstrual cycle. Due to the fact that the drug inhibits ovarian function, it can cause dysfunction or cyst formation. It is forbidden to take Postinor more than once per cycle, otherwise an ectopic pregnancy can be caused.

Contraindications. The drug is contraindicated in women suffering from uterine bleeding, epilepsy, heart disease and breast tumors.

Important!Postinor is a medication for emergency protection, so it can only be used in a hopeless situation. 3 weeks after taking the pill to make sure that the pregnancy did not take place. If the results are suspicious, you need to do .

Escapelle

Escapel is similar in principle to Postinor. The active ingredient in this drug is levonorgestrel, an analogue of the sex hormone progesterone, which suppresses ovulation. Cervical mucus becomes thicker and denser, and the endometrium becomes looser. Escapelle is 97% effective when taken within 72 hours of intercourse.

In cases of using the medication later than indicated in the instructions (72-90 hours), the effectiveness of the contraceptive effect will decrease to 84%.

How to use. Escapelle consists of one tablet, the second should be taken only if, after taking the first one, vomiting occurred, or another sexual intercourse took place.

Pros, cons and contraindications are the same as for postinor.

Important!Both Postinor and Escapel are sold in pharmacies without a doctor's prescription. They are not abortifacients, ie. cannot terminate a pregnancy that has already taken place. Their task is to prevent the fixation of a fertilized egg in the inner surface of the uterus. If implantation has already occurred, the drugs are ineffective.

Agesta

Agesta is also a Russian-made emergency contraceptive drug. The drug contains 100 micrograms of mifepristone. The effectiveness of the application within 3 days after sexual intercourse (rape) is 99%.

Agesta inhibits the maturation of the egg, and also changes the structure of the mucous surface of the uterus, so that the embryo cannot be implanted.

Advantages and disadvantages.

• pros. The drug contains a moderate dose of a steroidal antiprogestogen, so it does not have serious side effects. Menstruation usually occurs in the same month.
• Minuses. The disadvantage can be considered the inaccessibility of the drug, because it is sold mainly in the capital.

Jenale

The Russian-made Genale drug (Izvar-Pharma LLC) also contains 100 micrograms of mifepristone, and has a similar effect on a woman's body. It prevents the fetal egg from growing into the endometrium.

How to use.Genale is effective in for three days after intercourse. You need to take 1 tablet (10 mg).

pros. The drug has a non-hormonal origin, so it does not knock down the monthly cycle. Due to this, secondary infertility does not occur, and it can be used by minors in case of rape.

Minuses. The effectiveness of tablets depends on body weight. With normal weight, the effectiveness of tablets is 99%. In full - 65% in very full - 33%. Increasing the dosage does not improve the result.

Contraindications.Severe diseases (renal, liver failure, anemia, heart disease), a previous course of hormones and drugs that reduce blood clotting (artofen, heparin, aspirin, diclofenac, anticoagulants), mifepristone intolerance, breastfeeding.

Important!Alcohol neutralizes the effect of Genale. If menstruation does not start within 10 days after taking the medicine, you need to .

Which is better: postinor, genale or escapelle?

To answer this question, several points must be taken into account.

• Postinor and Escapelle contain hormones, so their effectiveness is higher than that of Jenale.
• Genale lasts longer than postinor and escapelle. Genale is effective on the third day after unprotected sex. Postinor or escapelle will help only on the first day.
• After taking postinor and escapelle, delays occur more often critical days and uterine bleeding.
• Hormonal drugs increase the likelihood of developing .

In all cases, if there is a delay when taking any drug, you need to contact a gynecologist, undergo a pregnancy test and, if necessary, dowithout delaying deadlines.

Means for medical abortion for up to 42 days

, - Abortion drugs. They have the same active ingredient mifepristone, so the principle of action for drugs is the same. Distinguishes drugs:

• Price difference.The drugs cost differently, since Mifegin is produced in France, and Mifepristone in Russia or China.
• Probability of forgery. It is believed that Russian drugs for medical abortion are more often counterfeited, so women are more confident in the French Mifegin, which goes through customs and other checkpoints.
• Efficiency. According to the reviews of doctors, Mifegin is more effective in the early stages. Mifepristone is more suitable for inducing labor. As an abortifacient, it has a lower effectiveness.
• Side effects. Patients claim that Mifegin has less pronounced side effects.

Ginestril

The analogue of Mifegin Ginestril has a lower dose of the active substance, therefore, as an abortifacient, it has low efficiency. It is more used for those cases when, due to improper use of emergency contraception, a complete abortion did not occur, but the woman received a large hormonal load. In this case, she is recommended a lighter drug, Ginestril, which will complete the expulsion of the fertilized egg. But as an independent abortifacient, Ginestril is ineffective.

Mytholian

Mifolian, which contains mifepristone, is also an antiprogesterone. It belongs to a new generation of medicines compared to mifepristone, so it has fewer side effects. At the same time, Mifolian is less effective as an abortifacient. Experts noted that in 5% of cases after application, a woman continues to develop pregnancy, in 7% of cases it is interrupted, but the fetus is not expelled, and in 3% there is severe bleeding requiring surgical intervention.

A huge minus of the drug: in the case of a preserved pregnancy, the drug has a negative effect on the embryo, so you have to have an abortion.

Pencrofton

Pencrofton also contains a high dose of mifepristone and is used both as an emergency contraceptive and to terminate pregnancies that have already taken place. Doctors often recommend this drug to patients for medical abortion, but they only use it in medical settings. It has a significant drawback - it causes severe bleeding.

Cytotec, Misoprostol

Cytotec or Misoprostol are similar in their action. Misoprostol is a placental hormone, and Cytotec causes uterine contractility. They cause an artificial miscarriage, thereby terminating the pregnancy. These drugs are recommended for abortions up to 42 weeks because the drug causes uterine bleeding.

Medicines for abortion up to 62 days

Medical termination of pregnancy - - is allowed up to 12 weeks or 74 days, but not for medical reasons, pregnancy in medical institutions is terminated no later than 62 days from the date of the last menstruation. At the 12th week, the production of progesterone in large quantities stops, so almost all pharmaceutical abortion medications based on progesterone blockers become ineffective. In addition, after 12 weeks, the formation of the placenta, which is responsible for the life support of the fetus, is completed.

Starting from week 7, special prostaglandin-based agents are used for medical abortion. These are active substances, the main purpose of which is to provide vital processes. So, in men, prostaglandins stimulate sperm motility, in women they provoke uterine contractility during childbirth, in newborns it blocks blood flow in the umbilical cord and dilates the arteries. A lack of prostaglandins makes labor difficult, and an excess provokes premature birth.

Prostaglandin-based abortion drugs are used exclusively in medical settings. They stimulate the contractility of the uterus, causing contraction of the myometrium. The cervix softens and opens, stimulating the expulsion of the fetus. Such strong medicines are treated in special cases, if a woman has or analyzes showed . Still, there is a risk of uterine bleeding and other complications.

Enzaprost-F

The drug Enzaprost-F has an active substance prostaglandin dinoprost, which acts on smooth muscles. Long rhythmic contractions contribute to the death and expulsion of the fetus. As an abortifacient, the drug is injected into the amniotic sac. After a certain time, another dose is administered to stimulate uterine contractions.

Prostin F2 Alpha

Prostin F2 Alpha has a similar effect on the body, but it is based on active substance prostaglandin F2-alpha. It is injected into the amniotic sac to stimulate smooth muscle contraction. Leads to termination of pregnancy for a period of 16-20 weeks.

The doctor closely monitors the patient for 48 hours. If the expulsion of the fetus does not occur, a mechanical abortion is performed. The drugs are not used if a woman has asthma, uterine fibroids, pathologies of the heart and blood.

Why are mifepristone-based products so popular?

Preparations based on mifepristone, Mifegin, Mifepristone, , Pencrofton, Mifolian, block the production of progesterone, the female sex hormone secreted from the onset of fertilization to 12 weeks in large quantities. Progesterone is responsible for the relaxation of smooth muscles, facilitating the implantation of the embryo into the uterine cavity. Mifepristone inhibits the production of progesterone and causes the production of prostaglandins, which stimulate uterine contractions. As a result, the cervix opens, and the rhythmic contractions of the uterus push the embryo out.

The benefits of drugs include:

• efficiency 98.6%;
• no need for anesthesia, as with an abortion or ;
• excludes the possibility of infection, the formation of adhesions of the fallopian tubes and scars;
• the uterine cavity is not injured;
• abortion is carried out without the risk of secondary infertility;
• the woman does not have a great psychological trauma, as after a surgical abortion;
• with the right Following the instructions does not cause bleeding and severe pain.

How to use means to terminate a pregnancy on an emergency basis

Emergency contraception drugs suppress estrogen production, so they do not induce abortion, but prevent pregnancy itself. The active component of Postinor levonogestrel inhibits the maturation of the follicle and at the same time affects the inner layer uterus endometrium. It becomes so loose that even if the egg is fertilized, the zygote will not be able to implant. In addition, the denser and more viscous mucus of the cervical canal does not allow the sperm to penetrate inside. the effectiveness of the drug depends on the speed of its application.

If the pill is taken 24 hours after intercourse, then pregnancy will not occur by 95%. If three days have passed, the effectiveness is halved.

Postinor is taken in two steps: the first time as soon as possible after intercourse, and the second tablet 12 hours later. The advantage of emergency contraceptives is that the menstrual cycle practically does not change, which is very important for young girls. However, they should not be applied regularly, maximum 2 times a year.

How are progesterone blockers used for medical abortion?

Medicines based on mifepristone and misoprostol are administered in two stages: the woman takes the first pill in the presence of a doctor. If she does not experience pain and bleeding, then she goes home. The second time he comes to the gynecologist after 2 days for an examination.

If the process of expulsion of the fetus is slow, the pregnant woman is given a second tablet, possibly of a different or the same drug. Within 2-3 days, the abortion should be completed. In case of severe bleeding, a woman goes to the same institution at any time of the day. After 14 days, she again goes to the reception. The doctor on ultrasound is convinced of the expulsion of the fetus. If the pregnancy persists, the woman is offered a surgical abortion.

Where to get a medical abortion in St. Petersburg

Honey termination of pregnancy can be carried out at. We use only certified products. The cost of the procedure includes an appointment with a gynecologist, ultrasound to determine the gestational age and abortion pills.

Medical abortion is prescribed only in the early stages, up to 49 - 63 days of pregnancy. But for a guaranteed good result, it is more effective to carry out this procedure for up to 28 days (4 weeks). At this stage of development, the fetal egg is still weakly connected to the uterus, so abortion is easier and the risk of hormonal failure is reduced. The effectiveness of the pharmaceutical board reaches 96%.

How long can a pregnancy be terminated?

The main advantage of this type of abortion is the absence of traumatic surgical intervention, which avoids many complications, the most dangerous of which are uterine perforation, secondary infertility and infection of internal organs. During a medical abortion, patients usually do not need anesthesia, since the pain is about the same as during menstruation. And the psychological trauma from a medical abortion is not so pronounced.

Before conducting a medical abortion, it is necessary to take tests for the content of antibodies to HIV and RW in the blood, as well as a smear for the presence of pathogenic flora.

There is no need to stay in the hospital for the procedure. At the gynecologist's appointment, the woman receives pills and goes home. Then it will be necessary to come to the appointment two or three more times, so that the doctor is convinced that the abortion was successful. And in case of complications, he could prescribe additional drugs.

But can all women have a pharmacological abortion? Of course, like any medical intervention, medical abortion has its absolute and relative contraindications.

absolute contraindications, when not to have a medical abortion are:

- intolerance to drugs used for medical abortion, allergic reactions to any of the drugs used, noted earlier.

- Many people ask how long it is possible to terminate the pregnancy, in case of choosing a medical abortion, this period is 6-7 weeks.

Diseases of the internal organs, in particular problems in the work of the adrenal glands, since the drug used in the pharmacotherapy violates the action of corticosteroid hormones. For the same reason, a severe form of bronchial asthma is a contraindication to the procedure, since drugs based on these hormones are used to treat it.

- suspected ectopic pregnancy. When referring a woman to a medical abortion, the doctor must make sure that the fetal egg is in the uterine cavity, so the procedure ectopic pregnancy not only useless, but also poses a threat to the life of a woman, in this case, a surgical operation is indicated.

• severe anemia, hemophilia and other pathologies of blood clotting, since abortion is associated with large blood loss.
• porphyria, a hereditary disease that causes disruption of the enzymes that affect the production of hemoglobin, with this disease, large blood losses are highly undesirable.
• uterine fibroids with nodules large sizes, as this disease creates a risk of heavy bleeding.
• inflammatory and infectious diseases of the female genital area, including venereal diseases.

There are also relative contraindications to medical abortion, in the presence of these diseases, caution should be exercised when using drugs that cause abortion.

Such contraindications include breastfeeding, since the substances taken by a woman during pharmacotherapy affect the composition breast milk Therefore, before the procedure, it is necessary to express milk, and do not breastfeed until the drugs are completely removed from the body. Although excretion is fast, a break in feeding can adversely affect milk production.

The procedure is also prescribed with caution in the presence of scars on the uterus after cesarean section, in this case, the pharmacist is carried out exclusively in the hospital and in the early stages up to 4 weeks.

A relative contraindication is pregnancy that occurred while taking hormonal drugs contraception or in the presence of an intrauterine device. In these cases, pharmabort is not recommended.

The patient's smoking is not in itself a contraindication to medical abortion, but in women over 35 years of age, this bad habit causes disruption of the blood vessels and the hematopoietic system, which is a relative contraindication.

Medical abortion, although it is considered a method of abortion without serious consequences, however, like any other medical manipulation, it can cause complications and side effects.

In some cases, uterine contractions are very strong, the woman feels contractions, as during childbirth. To reduce pain, you should take a painkiller that your doctor will advise. Symptoms similar to poisoning may appear, such as vomiting and diarrhea. If a woman vomited less than 2 hours after taking the drug, the procedure may not be effective. Very rarely, medical abortion is accompanied by fever, headaches, and a rash similar to an allergic one.

The most serious complication of a pharmaceutical abortion is an incomplete abortion, when either the fetus continues to develop, or a dead fetal egg or its particles remain in the uterus. In the first case, even if a woman changes her mind about having an abortion, leaving the pregnancy is very risky, since the risk of developing pathologies in the fetus is too high.

Severe and prolonged bleeding is also a serious complication. In all the cases described, it is necessary to resort to a surgical method of treatment.

Medical abortion does not affect a woman's fertility and she can get pregnant again almost immediately. Therefore, it is extremely important, when resuming sexual activity, to carefully protect yourself.

Women should remember that absolutely safe methods of abortion do not exist, in any case, gross interference with natural processes does not pass without a trace for the female body.

Medical abortion (up to 22 weeks) - performed using medicines(mifepristone, pencrofton), which provoke a miscarriage.

• Up to 9 weeks (63 days of delayed menstruation), medical interruption is possible on an outpatient basis;
• From 9 weeks - only in the hospital.

At the request of a woman, an abortion is carried out only up to 12 weeks.

In the late period from 12 to 22 weeks, abortion is carried out strictly if there are medical or social indications.

Medical abortion is performed on an outpatient basis at a gestational age of up to 9 weeks and provided that the pregnancy proceeds without complications.

In case of pregnancy in the period from 9 to 12 weeks and above, medical abortion is carried out only in a hospital. In drugs in this period, the effectiveness is somewhat reduced (the shorter the period, the more effective the drugs).

The procedure is performed with a drug called mifepristone (mifegin), which reduces the effects of progesterone, which is the main pregnancy hormone, and is used in conjunction with prostaglandins - these are drugs that can increase uterine contractions and help to reject the ovum.

Contraindications

• Large uterine fibroids (many nodes or a node larger than 4 cm and deforms the uterine cavity, there is a risk of bleeding);
• Allergic reaction to drugs included in the abortion scheme;
• Suspicion of ectopic pregnancy;
• Anemia, in which the hemoglobin level is less than 100 g / l;
• Hormonally dependent tumors;
• Hepatic, renal, adrenal insufficiency and some severe extragenital diseases (hereditary porphyria, severe bronchial asthma, glaucoma);
• Smoking over the age of 35 + long-term use of COCs and pregnancy caused by COCs (the risk of thrombosis increases, drug interruption can be used only after an additional study of the coagulating properties of the blood).

If pregnancy occurs against the background of an intrauterine device, the IUD should first be removed, and then it is also possible to apply medical termination of pregnancy.

When using a drug regimen, you can not breastfeed, so this method of abortion is not suitable for a nursing mother.

An alternative to medical abortion is vacuum aspiration.

How is a medical abortion performed?

The medical abortion procedure includes four visits to the gynecologist.

The abortion itself occurs in two stages: the first dose of the drug and after a day or two - the second dose. Bleeding occurs in the second stage and begins within 3-4 hours after taking the pill.

After two weeks, a follow-up appointment with a gynecologist is required.

Gynecologist visits:

• 1 visit: consultation and referral for tests;
• 2nd visit: taking the drug;
• 3rd visit, after 1-2 days: repeated administration of the drug;
• 4 visit, not earlier than in 14 days: control

Standard pre-abortion tests

• general analysis of blood and urine,
• blood group and rhesus,
• smears for purity and oncocytology,
• HIV testing,
• hepatitis B and C and syphilis.

First gynecological appointment

At the first appointment with a gynecologist regarding an unwanted pregnancy, a woman receives advice on available methods of interruption, receives referrals for examination and psychological counseling.

Before the start of the procedure, an ultrasound examination is mandatory, which serves as the basis for the appointment of an abortion and a method for excluding ectopic pregnancy.

If an ectopic pregnancy is suspected, the patient is prescribed a blood test for hCG twice with an interval of several days (the growth of the pregnancy hormone in a few days differs in the normal course of pregnancy and in an ectopic or missed pregnancy).

If the examination revealed an inflammatory type of smear or bacvaginosis, then medical abortion is carried out in the usual way with the simultaneous administration of antibacterial drugs as prescribed by the doctor.

Abortion requires the appointment of antibacterial drugs:

• In patients without risk factors for infection, examined for the presence of chlamydia: for the prevention of inflammatory complications, once a day of the procedure.
• In patients with identified chlamydial or other infection, as well as in the presence of risk factors for the addition of inflammatory complications (with bactaginosis earlier in the smear): a course for 7-10 days.

Second reception

The patient comes to the second appointment with the gynecologist with decision about the abortion and signs an informed consent for medical interruption.

The patient is given 1 dose of drugs: first, the drug mifepristone, which has an antiprogesterone effect, is used. Progesterone is a pregnancy hormone, and when it is blocked by the drug, a signal to interrupt and prepare the cervix for a miscarriage occurs.

Against the background of the use of 1 tablet for 1 day, there are no special changes in the woman's well-being. There may be a slight pulling pain in the lower abdomen, scant blood smearing, and sometimes nausea.

Important! In an Rh-negative mother and an Rh-positive partner, an injection of a dose of anti-Rh immunoglobulin is also recommended to prevent Rh incompatibility with the child in the next desired pregnancy.

Third visit to the gynecologist

At the third appointment with the gynecologist, after 24-48 hours, the patient is allowed to take the second part of the pills, which directly cause uterine contractions and miscarriage through the prepared dilated cervix. At different times, the doses of drugs and the method of administration differ (tablets can be prescribed to drink inside, put under the tongue, enter vaginally).

In 95% of patients, spotting begins within three to four hours after taking the drugs.

Almost always, women have symptoms that the doctor warns about in advance:

Cramping pains in the lower abdomen, which each woman suffers differently, depending on the pain threshold. For the purpose of pain relief, the patient can take a tablet of no-shpa, baralgin or ibuprofen. A miscarriage will occur after a few hours from the start of contractions.

Abundant bleeding during miscarriage (larger and stronger than normal menstruation). True bleeding is rare, in 0.2-1% of cases. A woman should be alerted by such a volume of blood loss, at which two sanitary pads of the maximum size are completely saturated with blood within an hour, and this is repeated during the second hour. In this case, the patient must call an ambulance, which will take her to the gynecological hospital. In the hospital with the development of bleeding, vacuum aspiration of the uterine cavity is performed.

An increase in temperature to 38.5 (common, is a common side reaction to the interruption tablet). You should go to the hospital if the temperature rise lasts more than 4 hours, with chills.

Diarrhea (observed in more than half of cases, is also side effect drugs).

Usually bleeding stops completely after 7-9 days. The longer the gestation period, the more abundant the bleeding. In some cases, brown spotting remains until the next menstruation, which can be considered the norm.

Fourth reception

4 reception at the gynecologist - control. The patient is examined on a gynecological chair, a control ultrasound of the pelvic organs is evaluated. Ultrasound is recommended to be performed 2 weeks after the miscarriage. By this time, the cavity and size of the uterus are reduced. Within 2 weeks after the abortion, the patient can take herbal preparations for uterine contraction: uterine collection, water pepper infusion.

After medical abortion

After medical termination of pregnancy, the patient is forbidden to have sex for 3 weeks. The ban on sexual activity is associated with an increased risk of infection due to the increased vulnerability of the inner surface of the uterus.

If you want to protect yourself in the future with the help of oral contraceptives, a woman should take 1 tablet from the package already on the first day after the miscarriage.

Menstruation usually begins 3-4 weeks after the procedure and is no different from normal. Slightly more abundant or more meager discharge is allowed, as well as not intense pulling pain during the first menstruation after medical abortion. Usually such violations occur after the procedure, carried out for periods of more than 6 weeks.

If the patient has decided to take oral contraceptives, then the cycle will be set in accordance with the scheme for taking them.

It is recommended to plan a new pregnancy optimally 6 months after the abortion. However, the body of each woman is individual, therefore it is strongly recommended to discuss this issue with a gynecologist.

Possible consequences

• uterine bleeding, requiring instrumental emptying of the uterus in a hospital (vacuum aspiration of the uterine cavity) and the use of means that reduce the uterus;
• incomplete abortion (the remains of the fetal egg are also removed using vacuum aspiration of the uterine cavity in a hospital);
• infectious complications (the risk of their development is less than 1% of cases);
• progression of pregnancy in a situation where there was no rejection of the fetal egg.

With the ineffectiveness of medical abortion and the progression of pregnancy, the patient is offered to terminate the pregnancy by vacuum aspiration.

There are no large studies on the teratogenic effects of drugs for medical abortion on the fetus, but 14 cases of fetal malformations after the use of this regimen are known. If the patient suddenly changes her mind and decides to carry a progressive pregnancy, she should be warned about these known cases.

Advantages of the method

• high efficiency of the method (95-98%);
• allows to exclude surgical intervention, trauma to the uterine mucosa and damage to the vessels of the myometrium;
• with medical interruption, a gentle, non-traumatic opening of the cervix occurs;
• medical abortion makes it possible to refuse general anesthesia;
• medical interruption is not a surgical procedure, so the risk of ascending infectious complications is very low (less than 1%);
• the risk of long-term consequences for the reproductive health of the patient is reduced, which is especially important for primigravida women;
• Psychologically, a medical interruption is easier for a woman to endure than a surgical operation under anesthesia.

Sources:

• Medical termination of pregnancy. Clinical guidelines (treatment protocol). - Ministry of Health of the Russian Federation, 2015.

There are two medical methods by which a pregnancy is terminated (abortion): either using special pharmaceutical preparations (medical or pharmaceutical abortion), or using a surgical operation. At the same time, the pharmabort has a less aggressive effect on the woman's body than a surgical operation.

Medical abortion: what is it?

With medical termination of pregnancy, surgery is not performed. The essence of the method is in the reception of special hormonal drugs that cause miscarriage in early pregnancy. After termination of pregnancy as a result of medical abortion, it is possible to become pregnant again in a month, since the procedure in most cases does not affect the reproductive functions of a woman (if there are no complications).

Why is this method considered sparing and what are its disadvantages

Why medical abortion is considered more gentle than surgery:

• the recovery process is much faster;
• the woman does not experience physical trauma and the risk of injury to the uterus;
• the risk of infertility is significantly reduced, since pharmaceuticals do not affect reproductive function;
• pain when using pharmaceuticals is either absent or minimal;
• anesthesia is not used, therefore, the risk of its negative impact is excluded;
• efficiency is 98-99%;
• no need for hospitalization;
• there is no risk of infection with hepatitis or HIV.

Disadvantages of medical abortion:

• the balance of hormones is disturbed;
• an impressive list of contraindications;
• it is possible to use drugs for pharmaceutical abortion strictly up to 9 weeks of pregnancy.

Under certain circumstances, a doctor may recommend a medical abortion for a woman for medical reasons:

• if a pregnant woman has serious pathologies that can harm the fetus;
• if the risk of manifestation of chromosomal pathologies is very high;
• if the pregnant woman permanently lives in an ecologically dangerous zone, which threatens the health and life of the unborn child;
• with a dangerous dependence in a pregnant woman - narcological, alcohol.

Medical abortion: when it is completely forbidden, and when it can be carried out with caution

Doctors can do medical abortion with special care , if:

• pregnant under 18 or over 35;
• the pregnant woman has epileptic seizures;
• a pregnant woman takes drugs that affect blood circulation for a long time;
• a woman has a menstrual cycle;
• high risk of bleeding in case of low levels of hemoglobin in the blood;
• the pregnant woman is seriously addicted to nicotine.

Medical abortion should not be performed , if:

• there is a risk of rupture of the walls of the uterus;
• defined ectopic pregnancy;
• at a gestational age of more than 9 weeks;
• with chronic pathologies of internal organs;
• if there is an infection in the genitals;
• at a high risk of allergy to the components of the pharmaceutical preparation.

How long can a pharmacist be carried out?

Medical termination of pregnancy is allowed until 9 weeks. As a result of taking the drug, the action of the hormone, which promotes the development of the embryo, is suppressed.

Names and cost of drugs for medical abortion

There are no drugs for pharmacist in Russia on free sale (in a pharmacy): their use is possible only on the recommendation of a specialist. The difference in the cost of medicines is quite large (from 1 to 5 thousand rubles) and, as a rule, depends on the country of origin.

There are several types of drugs for pharmaceutical abortion:

• with active ingredient mifepristone (manufacturers: France, Russia, China): usually the drug is used once, not on a full stomach, at a dose of 600 mg;
• with active ingredient misoprostol (manufacturers: Russia, China, India): applied once, after mifepristone, at a dose of 400 mg, on an empty stomach.

What happens during the action of the drug:

• the cervix opens;
• the fertilized egg detaches from the wall of the uterus;
• the activity of the uterus increases;
• the fetal egg is removed from the uterus along with bleeding.

How is a medical abortion performed?

To avoid problems after medical termination of pregnancy, the doctor advises the woman in detail about what happens at different stages of the procedure, as well as what lifestyle should be followed until the fetal egg leaves the uterus and after the pharmaceutical abortion. In addition, the doctor informs about possible complications.

After the consultation, the gynecologist conducts an ultrasound examination of the patient to be sure that there is no ectopic pregnancy, and also prescribes certain tests. After receiving the results of the examination, the woman signs an informed consent for the medical procedure.

The woman is given the required dosage of drugs (usually the two drugs described above) that suppress the synthesis of progesterone. A woman can take the drugs at home in accordance with the instructions and following the recommendations of the doctor. As a result of taking the drugs, the woman will experience the symptoms of spontaneous miscarriage.

After the miscarriage has occurred, the woman needs to visit the gynecologist again for an ultrasound scan: the doctor will see if everything is in order, if there are any particles of the fetal egg left in the uterus. Over the next two weeks, it will be necessary to undergo examinations several more times. If the particles still remain, the gynecologist will undertake an additional manipulation - their vacuum removal (aspiration).

Bleeding: how long does it last after pharmaceutical abortion?

For a week after a medical abortion, there may be bleeding, in intensity reminiscent of menstruation.

What are the negative consequences and complications after medical abortion

Even if a woman follows all the doctor's instructions, a pharmacist can have negative consequences and even complications of a different nature and duration.

Consequences lasting from a few hours to 1 week:

• nausea: the most common negative manifestation, usually occurs after taking drugs at a gestational age of about 6 weeks;
• vomiting: according to statistics, occurs in almost half of women when taking drugs orally and in a third - when taking them vaginal application;
• allergic reaction: usually manifests as a rash, less often breathing problems or Quincke's edema may occur; if a woman in ordinary life often suffers from allergic reactions, she needs to take the drug under the supervision of a doctor and then stay within the medical facility for several hours;
• diarrhea: according to statistics, occurs in a third of women after taking the drug orally and in a fifth - with vaginal use; usually resolves on its own, with diarrhea medication being ineffective;
• pain in the lower abdomen: is the norm and manifests itself in almost all women; pain can be mild, moderate or severe, usually appearing half an hour to an hour after taking the drugs; pain can be relieved with symptomatic anti-inflammatory painkillers - Nurofen, Ibuprofen, etc.
• Blood discharge: if the discharge is similar in type and volume to normal menstruation, this is the norm, their duration may be longer; if the discharge lasts for about a month, but does not cause pain and is not too plentiful - this is also considered the norm; with abundant discharge, accompanied by pain (especially severe), it is necessary to urgently consult a gynecologist;
• cramps in the lower abdomen: may occur a few hours after the use of drugs; a heating pad placed on the abdomen may help to relieve the symptom.

Consequences lasting from 1 week to a month:

• pregnancy, which, despite taking the drugs, continues, since the fetal egg or its remains could not leave the uterus: the cause may be an incorrect dosage of the drug, the use of the drug after 9 weeks of pregnancy; inflammatory processes in the body;
• prolonged (more than a week) pain and cramps in the lower abdomen: the cause may be the addition of an infection against a background of weakened immunity or particles of the fetal egg remaining in the uterus; to determine the exact cause, you need to contact a gynecologist who will see the problem on an ultrasound scan or during an examination;
• dizziness, headache: according to statistics, it occurs in a fifth of women who, with heavy discharge, lose a lot of blood; with such a symptom, it is better to consult a gynecologist;
• problems with the menstrual cycle: a delay in menstruation for a couple of weeks is considered the norm, since during this period after the use of drugs, the endocrine and reproductive systems seek to restore their disturbed state; a delay of a month or more can signal inflammation, so in this case you need to contact a gynecologist;
• inflammatory processes, infection accession: usually occur if particles of the fetal egg remain in the uterus; obvious symptoms will be purulent discharge with a greenish tint and a characteristic odor, accompanied by pain; it is necessary to contact a gynecologist, who, after removing the particles of the fetal egg, may offer to stay in the hospital for observation and prescribe antibiotics.

Complications occurring after months or years:

• infertility: may occur due to serious disorders in the hormonal system; as a result, adhesions may occur in the fallopian tubes, which prevents the egg from passing into the uterus; the presence of a negative Rh factor in a woman and a positive one in her partner is an additional risk factor for infertility;
• mental failures: hormonal disorders and emotional experiences about an abortion can manifest themselves in aggressiveness, increased irritability, or, on the contrary, in apathy and depression; if these changes become apparent and frequent, the woman should seek the help of a psychologist or possibly a psychiatrist.

What not to do after a medical abortion?

Restrictions to be observed after medical termination of pregnancy:

• resume sexual activity no earlier than 2-3 weeks after the use of drugs;
• visit the gym and give the body increased physical exercise including lifting heavy bags, carrying a child;
• strongly heat or supercool the body - take a bath, visit a sauna or bath, dress inappropriately for the weather.

A positive pregnancy test after an abortion: why does this happen and what to do?

After the pharmacist, you should make sure and conduct a pregnancy test. In some cases, it may show a positive result, which will indicate the remnants of the fetal egg in the uterus. In this case, the gynecologist will either aspirate (vacuum removal) of the remains from the uterine cavity, or remove them surgically.

Who should I contact for a medical abortion?

Professional skills:
Contract management of pregnancy from an early date;
Treatment of various forms of inflammatory diseases of the uterus and appendages;
Owns all possible small gynecological operations for the treatment of pathology of the cervix and endometrium;
Certified endoscopist;
Has a certificate in the specialty "Anesthesiology and resuscitation";
One of the leading specialists in ultrasound diagnostics of the Medical Academy "Healthy Generation";
Owns cutting-edge methods of intimate rejuvenation.

Women who are faced with an unwanted pregnancy often wonder how long it is possible to have an abortion, until what month the procedure is safe for health. Termination of pregnancy in any case entails some complications and the need for a recovery period. Everything happens individually and only after visiting the antenatal clinic.

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Description of the procedure

Abortion is forced termination of pregnancy through medical intervention. Translated from Latin, this word means "miscarriage."

According to the mechanism of manifestation, they distinguish:

1. Spontaneous, which occurs for a number of reasons most often in the first trimester without the initiative of a woman. Some encounter it even before they know they are carrying a child.
2. Artificial. This class includes all other types of abortions that involve third-party intervention at the initiative of the mother.

Causes of spontaneous miscarriage are very different:

• wrong way of life;
• weakness of the immune system;
• previous abortions;
• the use of hormonal contraceptives;
• smoking;
• sexual infections.

Regardless of the timing of an abortion, it is important to remember that this is an important step that requires a lot of responsibility. After a miscarriage, serious complications can follow, from cervical fibroids to failure to carry subsequent pregnancies and infertility in general. It is necessary to weigh all the pros and cons in advance.

Interruption methods

Abortions are legal in Russia, made before 22 weeks. At the same time, it is important at what time the abortion is done, since up to 12 weeks this happens at the request of the woman, from 12 to 22 - under certain circumstances.

These include cases where:

• the pregnancy was the result of rape;
• there are medical indications;
• A woman is declared incompetent after the death of her husband.

The answer to the question of how long a pregnancy can be terminated depends on the method chosen:

Medical

For medical termination of pregnancy, the first trimester is most favorable. The optimal period for an abortion is 45 days or 6 weeks.

Abortion is done with drug Mifepristone. The tool for several hours blocks the release of the hormone progesterone, which is responsible for preserving the fetus. As a result, a miscarriage occurs.

The advantages are:

1. there is no recovery period or stay in the hospital;
2. minimal risk of complications;
3. no damage to the cervix, as in the surgical method;
4. high efficiency;
5. the possibility of successful conception in the future;
6. such a method is psychologically easier perceived by women.

Medical termination of pregnancy occurs two hours after taking the drug and is accompanied by bloody uterine discharge. They can last for two weeks and be profuse. Also, the discharge is often accompanied by pain in the lower abdomen, this indicates a contraction of the uterus.

Important! If a copious discharge continue to be after two weeks, and the pain does not go away, you need to see a doctor or call an ambulance.

Three days after the medical interruption, you should begin to protect yourself, since conception is possible during this period.

Women who are in the early stages of gestation and do not want to keep the child are increasingly resorting to medication.

This method is much safer and more effective than surgery. Especially if before C-section, and the suture on the uterus has not yet healed to the end.

Plus, when using tablets, you do not need to be under the supervision of a doctor for a long time or use anesthesia.

Many people ask the question: how long can abortion pills be used. The effect of the tablets is the higher the earlier a woman decided to use them . The maximum term for abortion using pills is 6 weeks or 42 days from the first day of the last menstruation.

Important! As soon as a woman finds out that she is pregnant and decides to interrupt this process, one should not delay taking abortion pills.

If more than 6 weeks have passed since conception, and the doctor decides to terminate with pills, then the procedure is carried out in a hospital under supervision.

Miscarriage occurs under the influence of the following drugs:

Mifepristone	An effective drug that blocks the production of the pregnancy hormone progesterone. It is necessary to take 600 mg of the drug 2 hours after a meal. To consolidate the effect, 400 mg of misoprostol are prescribed.
Pencrofton	Analogue of Mifepristone tablets. Assigned to 600 mg at a time. 8-14 days after taking the pill, the patient should undergo an ultrasound scan.
Mifegin	It is a steroid that increases the tone of the uterus and leads to its active contraction. Drink the drug once, at a dosage of 600 mg.
Mytholian	The main active ingredient of mifolian is mifepristone. It has a similar effect by blocking the hormone progesterone. As a result, a miscarriage occurs.

Despite the fact that abortion pills are recognized as the safest means, there are a number of contraindications to their use:

1. malignant and benign uterine formations;
2. diseases of the gastrointestinal tract or kidneys;
3. high pressure;
4. poor blood clotting;
5. epilepsy.

Abortion pills have a lot of advantages:

• psychologically easy procedure
• takes little time
• does not cause complications.

However, it is very important to undergo an ultrasound examination 10 days after taking the pills to make sure of the result.

vacuum abortion

Vacuum abortion (or mini-abortion)- this is getting rid of the fetal egg by sucking it through a special vacuum nozzle

This method is less dangerous than instrumental, since damage to the uterus or the occurrence of infections is excluded.

Sometimes disputes arise as to how many weeks a vacuum abortion can be done, since sometimes it is carried out in the period up to 12 weeks.

Vacuum abortion is allowed for up to 6 weeks, subject to the normal development of the fetus. If the pregnancy is frozen, then it is possible to use a mini-abortion up to 12 weeks inclusive.

At too early a time, it is also not recommended to do it, since the fetal egg is still difficult to distinguish. Therefore, a woman who decides on a mini-abortion and is interested in how long this procedure is done should determine the type of pregnancy.

Late dates

Late abortion poses a health risk future mother's life. But there are situations when such a method is inevitable.

It is important to remember how long a pregnancy can be terminated. This period is 22 weeks. After 12 weeks, it is considered that this is already an abortion in the later stages, since the child has formed the main organs and systems.

The decision to terminate can only be made by a doctor for medical reasons:

• detection or severe genetic diseases;
• the mother has an infection or cancer.

It is important to remember that late abortion is very dangerous, so the decision is made not by one doctor, but by a council.

Process duration

Sometimes women are interested not only in the question of how long the whole procedure will take.

The later a woman decides to get rid of the fetus, the more dangerous the consequences for her health will be. It is important to remember how long a pregnancy can be terminated by different methods so that a long wait does not result in surgical intervention.

Useful video: how the abortion procedure works

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