Abortion is the process of terminating a pregnancy voluntarily because of certain circumstances that might occur. These can include undesired pregnancy despite the usage of protection, underage sex and so on. There are generally two methods of abortion and both of their own pros and cons. Abortion can be successfully conducted in one day, so the person getting it does not have to stay overnight in order to get it.
Duration of pregnancy
The number of days or weeks since the first day of the woman’s last normal menstrual period (LMP) in women with regular cycles. For women with irregular cycles, the gestational age may need to be determined by physical or ultrasound examination. In India, abortion (MTP) is permitted up-to 20 weeks of pregnancy.
There are two methods by which abortion can be done
1. Medical Abortion -Non-surgical abortion in which medicines are used to induce abortion
2. Surgical Abortion - Use of transcervical procedures for terminating pregnancy, including vacuum aspiration, and dilatation and evacuation (D&E).
Medical abortion in India is approved only up-to 7 weeks (49 days) of pregnancy.
Medical abortion can be done up-to 9 weeks (≤63 days) according to WHO – World Health Organization.
Advantages of Medical Abortion
Avoids surgery. Controlled by the woman and may take place at home. No need for admission to the Hospital. Usually well tolerated by women if properly counselled and motivated. No need to take leave from work, as bleeding can be manged with menstrual pads even while in office or at work.
Disadvantages of Medical abortion
Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.
Method of Medical Abortion
Mifepristone (200 mg) is always administered orally at first visit.Then Misoprostol (4 tablets = 800mcg) administered by different routes, including oral, vaginal, buccal and sublingual. Vaginal route is preferred as chances of success is much higher and lowest rate of side effects; as compared to other routes. For women having medical abortion, routine use of prophylactic antibiotics is not recommended.
When to seek medical attention during medical abortion
1. Prolonged or heavy bleeding (soaking more than two large pads per hour for two consecutive hours);
2. Fever lasting more than 24 hours;
3. Feeling generally unwell more than 24 hours after misoprostol administration.
It can be performed upto 12 weeks of pregnancy either by Vacuum aspiration or by Dilatation and evacuation (D&E).
Advantages of Surgical Abortion
Quick procedure. Complete abortion easily verified by evaluation of aspirated products of conception. Takes place in a Hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled.
Disadvantages of Surgical abortion
Requires instrumentation of the uterus. Small risk of uterine or cervical injury. Timing of abortion controlled by the Doctor and Hospital. Anaesthesia wneeds to be administered. Most doctors perform this procedure under short general anaesthesia. Woman needs to be in the Hospital for at least 6 hours. Effect of sedation will be there through out the day.
All women having surgical abortion, regardless of their risk of pelvic inflammatory infection, should receive appropriate prophylactic antibiotics pre- or peri-operatively.
<= 7 weeks - Medical method or Surgical method 7-12 weeks - Surgical abortion 12 – 20 weeks – Medicines with or without surgical procedure in Hospital.
The following tests, when available, may be performed on the basis of individual risk factors, findings on physical examination, and available resources:
1. pregnancy test if pregnancy is unconfirmed;
2. Haemoglobin (Hb) for suspected anaemia;
3. Rhesus (Rh)-testing, where Rh-immunoglobulin is available for Rh-negative women;
4. HIV testing/counselling;
5. Other laboratory tests as indicated by medical history (kidney or liver function tests, etc.);
6. Ultrasound, if indicated, to confirm pregnancy dating or the location of the pregnancy.
Pain, Bleeding, Fever, Nausea and vomiting, Diarrhoea, Pelvic infection
"Authored By Dr.Niraj Mahajan"
MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.Read more [+]