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Medical method for terminating pregnancy for medical reasons. Medical indications for termination of pregnancy: diseases of a woman. Social indications of termination of pregnancy

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Try to calm down and not panic. Screening alone does not prove anything yet. The equipment malfunctions, doctors make erroneous diagnoses. Especially in the early stages, when the child's internal organs have not yet fully formed. You have hope, just forget about depression for a while and turn on the "Cold head" mode.

Go to the group of your hometown and ask the mothers which specialist is best to contact in order to get a 100% correct ultrasound scan. You may have to go to the metropolis or go to a private center. Make an appointment with a paid gynecologist or even find contacts of the luminary of medicine. Believe me, women will definitely help, share information and support. Sometimes on the Internet you can come across the relatives of talented doctors who will agree with a gynecological sister about a consultation.

Yes, modern medicine has achieved a lot, but still, mistakes do happen. And so that you then do not cry at night and do not think that the specialist has deceived or made a false diagnosis, you need to consult with several people. And only then make the final decision.

Don't worry if your child is perfectly healthy, frequent ultrasound examinations will not harm him. Will not lead to mutations or the threat of miscarriage. The main thing is to be less nervous until the experts make an accurate verdict. After all, stress negatively affects the embryo and the health of the mother.

Ray of hope

Not all dire diagnoses are incurable. If your child has been diagnosed with heart or other internal organ defects, you may be offered surgery. Surgery is a last resort. More often, doctors think about this scenario if:

  • a woman is closer to 35-40 years old;
  • a mature lady has her first pregnancy;
  • the patient had to resort to IVF;
  • she will not have more chances of becoming a mother;
  • the defect can be corrected.

Young girls are given a referral for an abortion. Doctors believe that the twenty-year-old patient still has a lot of time left to conceive a healthy child. In addition, intrauterine surgery to eliminate defects is not performed in all clinics. Domestic surgeons and gynecologists have insufficient qualifications and do not have the appropriate equipment. If you want to take the risk, you will have to spend a lot of time and effort looking for a qualified specialist and a hospital.

How does all this happen? The woman is given anesthesia and the abdomen and uterus are cut open. Then the operation is performed on the child without removing it from the mother's womb. Fruit waters are replaced with solutions that create an ideal environment for the development of a small life. And they help mom to bring the baby to the due date.

Things don't always go smoothly. Sometimes the mother or child has complications. And then you still have to resort to abortion or artificial childbirth. Therefore, be prepared for any, even a sad outcome. But still believe in the best.

Difficult decision

Not all pregnancies can be saved. The mother may be diagnosed with diseases that are incompatible with bearing a child. For example, malignant tumors, encephalitis, or meningitis. In such situations, there is only one way out. Unfortunately, this is an abortion.

Medical indications for abortion are genetic abnormalities in the embryo. For example, Down syndrome. Yes, some vices are compatible with life. More precisely, existence. Children with genetic diseases are born with disabilities. They develop slowly, cannot move and are completely dependent on those around them.

If pregnancy does not threaten the life of the mother, then the woman is given the right to choose. Preserve the embryo or have an abortion. And this is the most terrible moment, because the patient thinks that she is killing the child with her own hands. If you are haunted by dark and depressing thoughts, then think about the future of your baby.

Imagine that the baby was born on time. And immediately got into intensive care. You stayed at home for several weeks, and then again went to the hospital, because a baby with vices needs constant medical care. Your whole life will turn into continuous droppers, passing the commissions that should assign a disability pension. Search for specialists, regular examinations and expensive treatment.

But this is not the worst thing. The main nightmare is the child's complete dependence on you and her husband. What happens when you get old? And you will not be able to care for a disabled person. Or leave this world? And the child will be left all alone. Perhaps he will end up in an orphanage where nurses don't give a damn about the sick.

When the baby is in the womb, you don't want to agree to an abortion. It seems that the world will collapse, and the meaning of life will disappear. But try to think not only about the present, but also about the future. And it will turn out to be gloomy and hopeless. Do you want your son, doomed to a miserable existence, to hate his mother? In addition, no one guarantees that the child will live to adulthood.

Children with serious pathologies and genetic abnormalities die early. But at first they suffer for a long time in hospitals. And you suffer with them. When you look at a tiny body with droppers and tubes sticking out of it. When you listen for interrupted breathing. When you try to explain to a three-year-old what death is. And when you choose the coffin that's meant for him.

You know, sometimes abortion is not a punishment, but salvation. Not just for you, no. First of all, for the child. He will not even feel anything and will not face pain, torment and real life, in which, alas, there is often no place for disabled people. And if you chose this path, then do not blame yourself. Just remember that you didn't kill the child, you did him a huge favor.

Late abortions

It is much easier for a woman to come to terms with early abortion. When an embryo looks more like a frog embryo, it is not associated with an infant. But some defects are discovered too late, at a period of 16 to 22 weeks. When a noticeable tummy is formed in the mother, and the fetus begins to actively move.

It is very difficult for a woman to decide on an abortion, even if she understands that a newborn will live no longer than a few days or hours. Tantrums and prolonged depression are a natural reaction to a situation. But you still have to make a decision.

If doctors sent for an abortion because the fetus froze, surgery cannot be avoided. But if the child is developing normally, it is just that he was diagnosed with serious pathologies or genetic mutations, you have the right to leave him. In both the first and second cases, you will have to endure contractions and attempts. Late surgical abortion is contraindicated. In women in labor, artificial childbirth is induced with the help of oxytocin and special algae that dilate the cervix.

Some parents who know that the child has a fatal pathology still refuse to terminate the pregnancy. This usually happens in religious families. They decide to deliver the fetus before the due date and spend at least a few hours with the newborn. And then bury it according to all the rules.

Late abortion is a terrible ordeal for every pregnant woman. And you deserve to be depressed. You can cry for several days in a row. Don't talk to relatives. Hate everyone around you. Shouting, swearing and smashing dishes. Spill out the emotions that are choking you. Don't try to hold back your grief so you don't hurt those around you. The choice rests only on your shoulders. And no one else in the world can understand your feelings.

It will be very painful and difficult at first. Women want everything that happened to them to be a terrible dream. They dream that they will open their eyes in the morning and see a growing tummy or a peacefully sniffing baby. Or they will realize that they have become victims of a nightmare, but in fact there has never been a second strip on the test.

What they fear most is not physical pain, but mental pain. When you cannot look at the pictures of children, and pregnant girls walking around the city cause hysteria and a desire to escape to the ends of the world. But gradually the aching feeling in the chest will subside. There will remain only a chronic longing for a miracle that never happened. Although it will pass one day.

Acceptance and humility

If you have to give up your dream of becoming a mom, give yourself time to grieve. In the first weeks or months, you don't have to be cheerful and cheerful. And she is not obliged to console her spouse. Or pretend that nothing terrible has happened.

Don't try to suppress your grief. If you hide it in the depths of your subconscious, it will not disappear, but only hide for a while. And when the test shows the second strip again, it will break free and turn your life into hell. To make the pain go away, you need to cry it out. Suffer, and then throw aside old memories that prevent you from moving on.

Try to get psychotherapy. It doesn't matter how long you have had an abortion. The termination of a long-awaited pregnancy is a tragedy that needs to be worked out with a specialist so that it does not cross out your future.

Healing begins with accepting what happened. And forgiveness. Do not blame yourself. No woman is immune from a terrible diagnosis. Even healthy couples have sick children. Only nature and chance are to blame.

No, you are not a killer, but a good mother who only wanted happiness for her child. If you are a believer, then consider that abortion has become your test of strength. And you took sin on your soul to save a little life from torment and suffering, so you deserve forgiveness and respect for your courage.

Care and care

Don't punish yourself. Self-flagellation won't change anything. Will not bring the child back, but it can undermine your health. And then you definitely won't be able to become a mom. If you want to try again, then take care of yourself. First, follow the recommendations of your gynecologist. Drink antibiotics, anti-inflammatory, buy vitamins and have regular check-ups. Observe sexual rest in the first 1-2 months after an abortion so that the body has time to recover. Also, don't forget about contraceptives. Of course, some women want to get pregnant as quickly as possible, but it's better to wait at least six months.

Second, do things that bring you pleasure and comfort. Some women escape depressive thoughts by knitting or beading. Others watch TV shows or read books for days. Still others try not to be alone. They meet with their girlfriends, go to work right after the abortion, or even sign up for volunteers.

If you have not abandoned the idea of ​​becoming a mother, then try to undergo a comprehensive examination with your husband. Be sure to visit Genetics. It is this specialist who will help you figure out why the child has developed a defect, and will tell you how high the likelihood of a repetition of the situation is. Thanks to genetic testing, you will be able to conceive a healthy baby. Or even several.

To help your body and mind recover faster, try to avoid traumatic factors. For example, in the first months, do not meet with girlfriends who are expecting a baby or have recently become mothers. Bulging tummies and pink-cheeked babies will make you think that you, too, could walk with a stroller, rock your baby and show off new booties tied with your own hands.

Most importantly, remember that you are not the only one. Thousands of women have experienced medical abortions. And they also managed to survive this difficult period. Try to talk to girls like that. Find them on forums or social networks. Women who have gone through the same thing quickly find a common language. Perhaps it is support and similar stories that can dull your pain and give you hope.

Some women are helped by confessions. If you believe in God, try going to church and talking to a priest. An adequate clergyman can replace a psychologist if you do not have the ability or desire to go to a doctor. The main thing is that your mentor does not try to suggest that you are to blame for what happened. Otherwise, he is not trustworthy.

Biggest fear

Women who have experienced an abortion for medical reasons are afraid of re-pregnancy. No, on the one hand, they dream of a second strip. But on the other hand, they fear that the situation will repeat itself, and they will have to go through the whole nightmare anew.

Discuss your fears with a psychologist and gynecologist. Treat chronic diseases and strengthen the immune system. And don't set yourself up for negativity. Remember that after children with fatal pathologies, healthy babies are born who do not even have a cold. But you must approach conception responsibly.

You will not be able to completely get rid of fears. Young mothers are afraid of the first and second screenings, with bated breath they are waiting for the test results to be shown. And then every night they listen to the sniffing of the newborn. Unfortunately, the memories of the nightmare lived through the memory for decades. But they do not prevent you from becoming happy.

Dear reader, no one will understand what pain a woman experiences when she is forced to have an abortion. And neither husband nor relatives are able to find words that could comfort you. Only time and an adequate psychotherapist can cope with grief. Do not be afraid to contact specialists and ask for help. And don't give up. For the baby you lost.

Medical abortion - artificial termination of pregnancy, performed by trained medical personnel in compliance with all the requirements of the method. Medical abortion is carried out in a medical institution with the informed consent of the woman and the obligatory execution of the appropriate medical documentation. Artificial termination of pregnancy is carried out at the request of a woman up to 12 weeks of pregnancy; for social reasons - up to 22 weeks, and in the presence of medical indications and the woman's consent - regardless of the duration of pregnancy.

INDICATIONS FOR MEDICAL ABORTION

At their own request, women terminate pregnancy for up to 12 weeks upon presentation of a referral from a antenatal clinic, a passport and a policy at an institution operating under the compulsory health insurance program.

For medical reasons, termination of pregnancy is carried out regardless of its duration in the event that pregnancy and childbirth can worsen the woman's health and threaten her life, or if abnormalities in the development of the fetus are found. The indications are established by the attending obstetrician-gynecologist together with specialists of the relevant profile (therapist, surgeon, oncologist, psychiatrist, etc.) and the head of the medical institution after examining the patient in a hospital setting. At the same time, the woman writes a statement, which is considered by the medical commission.

For social reasons, pregnancy termination is carried out for up to 22 weeks. Decree of the Government of the Russian Federation of August 11, 2003 compiled a list of social indications for induced abortion: a court decision on deprivation or restriction of parental rights; pregnancy resulting from rape; a woman's stay in places of deprivation of liberty; disability of the I-II groups in the husband or the death of the husband during pregnancy. The question of termination of pregnancy for the listed indications is decided by the commission after the conclusion of the obstetrician of the antenatal clinic on the duration of pregnancy and upon presentation of the relevant legal documents. If there are other non-medical grounds for termination of pregnancy, the commission decides on this termination on an individual basis. The commission includes the chief physician or his deputy for medical work, the head of the department, the attending physician, as well as specialists: a lawyer, a psychiatrist, etc.

CONTRAINDICATIONS OF MEDICAL ABORTION

  • Inflammatory processes of the genital organs.
  • The presence of purulent foci, regardless of their location.
  • Acute infectious diseases.
  • Late pregnancy. In late terms, abortion is contraindicated if termination of pregnancy during this period is more dangerous to health and life than continuation of pregnancy and childbirth.
  • The term is less than 6 months after the previous termination of pregnancy.

PREPARATION FOR ARTIFICIAL INTERRUPTION OF PREGNANCY

Before termination of pregnancy, a preliminary outpatient examination is carried out: collection of anamnestic data; bimanual examination with examination of the cervix in the mirrors; determination of the degree of cleanliness of the vagina; clinical blood test; general urine analysis; determination of blood group and Rh factor; blood test for HIV infection, syphilis, hepatitis B and C; analysis of the blood coagulation system (according to indications); Ultrasound of the pelvic organs; examination by a therapist. If necessary, appoint consultations with other specialists.

MEDICAL ABORTION

One of the safest methods of artificial termination of early pregnancy as an alternative to surgery is medical abortion. In the Russian Federation, the use of this method is allowed up to 6 weeks of pregnancy (duration of amenorrhea 42 days). For this purpose, antiprogestins (mifepristone ©) are used in combination with prostaglandins (misoprostol). The patient takes 600 mg of mifepristone © orally (3 tablets) once, and after 36–48 hours, 400–800 mcg of misoprostol is prescribed orally. The effectiveness of the method, according to the WHO and Russian studies, is 95–98%. After termination of pregnancy, ultrasound control is required.

MINI ABORT

In the first trimester, up to 5 weeks of pregnancy, a mini-abortion (vacuum aspiration) is performed to remove the ovum from the uterine cavity. An electric pump and cannulas with a diameter of 5 to 12 mm made of flexible rigid plastic or metal are used. The efficiency of the method is 99.8%. After termination of pregnancy, ultrasound control is performed.

MEDICAL ABORTION

Removal of the ovum within 6–12 weeks is performed by scraping the walls of the uterine cavity (dilatation of the cervix and curettage) in a gynecological hospital.

PREPARATION FOR OPERATION

On the eve of a planned operation, a woman takes a shower, she is given a cleansing enema, and her hair is shaved off the external genital organs. On the day of the operation and the night before, it is forbidden to eat. If the abortion is to be performed under general anesthesia, the woman is examined by an anesthesiologist. Before the operation, you must empty your bladder and bowels. To prevent possible complications in the early postoperative period, it is recommended to take prophylactic doxycycline: 100 mg 1 hour before surgery and 200 mg after surgery.

ANALYSIS METHODS

Intravenous anesthesia, mask.

OPERATING TECHNIQUE

Medical abortion is performed in a small operating room in the position of a woman on a gynecological chair. The set of instruments includes vaginal speculum, bullet forceps, uterine probe, set of Gegar's dilators No. 4-12, curettes No. 6, 4, 2, forceps for removing the ovum (abortion), forceps (or forceps), sterile material.

The sequence of actions during the operation.

1. A two-handed vaginal-abdominal examination is performed to determine the size of the uterus, its position in the small pelvis and to exclude contraindications to surgery.

2. Treat the external genitals, vagina and cervix with iodonate solution or other antiseptic.

3. The speculum is inserted into the vagina.

4. Take the cervix with bullet forceps by the front lip. The front mirror is removed, the rear one is handed over to the assistant sitting on the left. To straighten the cervical canal, the cervix is ​​pulled downward and posteriorly (with the position of the uterus in anteflexio) or anteriorly (with the position of the uterus in retroflexio).

5. A uterine probe is introduced into the uterine cavity to clarify the position of the uterus and measure the length of its cavity. The curvature of the uterine probe and the depth of its insertion determine the direction of insertion of Gegar's dilators up to No. 11-12.

6. Gegar's dilators are introduced sequentially somewhat further than the internal pharynx. The insertion of dilators helps to stretch the muscles of the cervix. Attempting fixed insertion of dilators can lead to rupture and perforation of the cervix and body of the uterus. Each dilator is held with three fingers in order to carefully pass the internal pharynx and stop the movement of the dilator immediately after overcoming the resistance of the pharynx. If there is difficulty in inserting the dilator of the next number, return to the previous one, grab the posterior lip of the cervix with bullet forceps and hold the dilator in the cervix for some time.

7. Remove the ovum using curettes and abortion. Parts of the ovum are removed by abortion. Scraping begins with a blunt curette No. 6, then, as the uterus contracts and its size decreases, sharper curettes of a smaller size are used. The curette is carefully inserted to the bottom of the uterus and, by movements towards the internal pharynx, sequentially along the front, right, back and left walls, the ovum is separated from its bed. At the same time, the casings are separated and removed. After checking the area of ​​the trumpet corners with a sharp curette, the operation is completed.

In the case of complete removal of the ovum during scraping, a crunch is felt, the uterus contracts well, bleeding stops. The average blood loss during termination of pregnancy at 6–9 weeks is about 150 ml.

It is advisable to control the completeness of the emptying of the uterus from the elements of the ovum using ultrasound (especially in nulliparous).

After artificial termination of pregnancy, women with Rh-negative blood are immunized with human immunoglobulin anti-rhesus Rho (D).

The length of stay in a medical institution after an abortion is determined individually, depending on the woman's health status.

INTERRUPTION OF PREGNANCY IN THE II TRIMESTER

There are various methods of termination of pregnancy in the II trimester (for medical and social reasons):

  • The use of prostaglandins (intra-amnional, extra-amnional, parenteral, vaginal).
  • Amnioinfusion of hyperosmolar solutions (20% sodium chloride solution).
  • Hysterotomy.
  • Combined methods.

COMPLICATIONS

COMPLICATIONS OF ABORTION

  • Hypotension of the uterus with bleeding.
  • Incomplete removal of the ovum after scraping.
  • Perforation of the uterus.
  • Rupture of the cervix.

COMPLICATIONS IN THE POSTOPERATIVE PERIOD

  • Hematometer.
  • Exacerbation of inflammatory diseases of the internal genital organs.
  • Placental polyp.

REMOTE COMPLICATIONS OF ARTIFICIAL ABORTION

  • Inflammatory diseases of the uterus and appendages (14.6 and 19.2%).
  • Violation of the menstrual cycle (8–42.4%).
  • Isoimmunization with Rh incompatibility.
  • Violation of the patency of the fallopian tubes with the development of infertility or ectopic pregnancy.
  • Damage and degeneration of the endometrium, the formation of synechia in the uterus, leading to impaired implantation and the occurrence of fetal malformations.
  • Damage and cicatricial changes in the internal pharynx and cervical canal, leading to isthmicocervical insufficiency and miscarriage.
  • Psychogenic disorders.
  • The adverse effect of induced abortion on the functional state of the cardiovascular, endocrine, nervous and other systems of the female body.
  • Complicated course of subsequent pregnancy: an increase in the frequency of the threat of termination and miscarriage of pregnancy, the development of late toxicosis, the risk of bleeding during childbirth, weakness in labor, an increase in the frequency of birth of children with low body weight.
  • Repeated induced abortions are the cause of the pathological course of menopause.
  • Increased risk of developing dyshormonal diseases and breast cancer in women with three or more induced abortions in history.

FEATURES OF POSTOPERATIVE PERIOD MANAGEMENT

In the postoperative period, it is necessary to monitor body temperature, pulse rate, and secretions from the genitals. The external genitals are washed with antiseptic solutions twice a day. After discharge from the hospital, observation in the antenatal clinic is recommended. Peri or postoperative antibiotic prophylaxis of infectious complications is indicated for patients with a high infectious risk. In order to normalize the pituitary-ovarian relationship and prevent endometriosis, COCs are prescribed for 3 months.

PATIENT INFORMATION

  • After an abortion, it is advisable to consult a doctor about the selection of contraceptives.
  • It is necessary to refuse to take a bath (preferably a shower), swimming in pools and open bodies of water for the first 14 days.
  • Carefully observe the hygiene of the genitals, wash yourself daily.
  • It is necessary to observe sexual rest for 21 days to prevent the possible introduction of infection into the uterus, which after an abortion is a large open wound. Sexual life should begin after the first menstrual period, which will come after an abortion.
  • The bladder and bowels should be emptied regularly for better uterine contraction.
  • During the week after the abortion, measure the body temperature daily, avoid hypothermia, heavy physical activity.
  • An urgent need to consult a gynecologist in case of a rise in temperature, the appearance of pain above the bosom or in the lower abdomen, bloody discharge from the genital tract.
  • An urgent need to consult a gynecologist if menstruation came earlier or did not come as expected. The timing of menstruation before and after an abortion is the same.

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If necessary, all types of abortions are performed in our clinic, the cost of which depends on the chosen method. The method used in most cases is selected based on the duration of pregnancy and medical indications. In total, there are three ways in modern medicine to interrupt this process:

Interrupt method

Terms of termination of pregnancy

Anesthesia

What's included

Price

Vacuum abortion

mini-abortion procedure using a special vacuum aspirator device, cat. removes the ovum from the uterus with minimal injury.

Up to 7-8 weeks of pregnancy

Local or medication sleep

Consultation with ultrasound

2300 rubles

3700 rubles

Operation

6000 rubles

Pain relief and

stay in the ward

3000 rubles

Total: 15,000 rubles

Surgical abortion - scraping of the ovum from the uterine cavity

Up to 12 weeks pregnant

General anesthesia

Consultation with ultrasound

2300 rubles

HIV, RW, HBc, HCv, clinical blood test, group and Rh factor, smear for flora

3700 rubles

Operation

6000 rubles

Pain relief and

stay in the ward

3000 rubles

Total: 15,000 - 21,000 rubles

Medical abortion - pill termination of pregnancy

Up to 5-6 weeks of pregnancy

Does not require special methods of pain relief

Consultation with ultrasound

2300 rubles

HIV, RW, HBc, HCv, clinical blood test, group and Rh factor, smear for flora

3700 rubles

Drugs

3000 rubles - mifepristone (China)

6000 rubles-miropristone (Russia)

8500 rubles - mifegin (France)

Stay in the ward

Only 9.000 - 14.500 rubles

Advantages

Gynecologists of the highest category


Modern equipment


Medication sleep without general anesthesia


Control ultrasound


Constant communication with the doctor by phone

Early termination of pregnancy is the most preferable for maintaining health, so the decision about whether to keep the baby or have an abortion is best made as early as possible. If the procedure is performed by a qualified doctor, the likelihood of serious consequences for the body is minimal.


Contraindications

Consequences of abortion and prevention of complications

All procedures for termination of pregnancy in "Medicine and Beauty on Paveletskaya" are performed by highly qualified doctors, in strict accordance with medical standards and norms. The staff of our clinic takes maximum care of the preservation of the reproductive health of their patients.

Doctors of the clinic "Medicine and Beauty on Paveletskaya" warn that the consequences of an abortion may be irreversible! Do not try to solve the problem yourself - contact the specialists! We adhere not to a quantitative, but to a qualitative, individual approach to each patient, while taking into account all the circumstances that forced a woman to resort to this procedure.


In case of termination of pregnancy, a preliminary medical examination is mandatory. It is carried out in order to establish the exact date of conception, as well as to exclude diseases and inflammatory processes in the body, and to prevent the negative consequences of abortion.


Description of the procedure

Types of abortions in the clinic "Medicine and Beauty on Paveletskaya"

  • Medical termination of pregnancy (pharmabort) is one of the most modern and low-traumatic methods. Usually it is used in the early stages - up to 5 weeks. After taking the drugs, the embryonic membranes are separated in the integument of the uterus, then, thanks to the increased contractions of the uterine muscles, the ovum spontaneously is pushed out. In contrast to the instrumental method, pharmaceutical abortion is much safer, due to which this technique has found wide application in our country and abroad. With an interval of 36-48 hours, the woman takes special medications based on mifepristone, which lead to the expulsion of the ovum. Such pills cannot be bought and used on your own! They are taken only under medical supervision. This is the best solution if you are at an early date or are pregnant for the first time. The cost of termination of pregnancy in this case depends on the chosen medication. We use drugs of Russian and foreign production for the pharmaaborte: accurate information will allow us to clarify the price list.
  • Vacuum aspiration (mini-abortion) it is distinguished by its low price and low invasiveness. For gestational age from 5 to 8 weeks, the specialists of our clinic recommend a mini-abortion procedure, which is performed using a vacuum aspirator - a special device that sucks out the ovum. The healing process takes place very quickly, which is a big plus of this technique. At the same time, the patient is not required to stay in the hospital for a long time.
  • Surgical abortion can be done at the request of the woman herself for a period of five to twelve weeks. Later carrying out is possible only if, as a result of diagnostics, serious developmental pathologies are found in the child, or pregnancy has occurred as a result of rape, or it poses a threat to the life of the expectant mother. A large abortion, as the patients often call it, is recommended by our doctors for termination of pregnancy from 8 to 12 weeks. Its essence consists in scraping the ovum from the uterine cavity. The procedure is performed under general anesthesia.

Which abortion is best suited in a given situation can only be decided by a gynecologist! Before deciding to terminate your pregnancy, sign up for a consultation with a gynecologist at the Medicine and Beauty on Paveletskaya clinic in Moscow.

Our doctors

The clinic "Medicine and Beauty on Paveletskaya" employs gynecologists with vast practical experience, who know all the nuances of the female body and take into account all possible contraindications for carrying out certain interventions. Therefore, a preliminary medical examination is mandatory in case of termination of pregnancy. In the clinic "Medicine and Beauty on Paveletskaya" it is carried out in order to establish the exact date of conception, indications and contraindications for this method.

When the happiness of a pregnant lady is overshadowed by a formidable verdict of doctors, she has to decide on a serious step - an abortion for medical reasons. Such an interruption of gestation by an artificial method is carried out in two cases - when gross malformations are found in a baby, or when a woman's diseases are incompatible with pregnancy. Depending on the term, the procedure is carried out by various methods, and the procedure takes place only in a hospital setting. Let's consider the official medical indications for termination of pregnancy, what complications can arise and how to survive the "post-abortion syndrome"?

For medical reasons, pregnancy can be stopped unscheduled at any time. The method of abortion is closely related to gestational age.

Until the end of the 1st trimester, the so-called early termination is performed. It is noteworthy that during the first trimester, a woman has the right to apply with a request to terminate a pregnancy, even without compelling evidence. Taking into account the term and condition of the woman, the obstetrician will select the optimal method of abortion - instrumental or medical abortion.

After 12 weeks, late termination of pregnancy is carried out for medical reasons. Between 12 and 22 weeks, various abortion techniques can be used, after 22 gestational weeks - only artificial stimulation of delivery.

The method of interrupting gestation depends not only on the period, but also on the clinical picture, the qualifications of the obstetrician-gynecologist, his experience and the technical base of the clinic.

Specialized medical institutions terminate pregnancy with the following methods:

  • Medication interruption. Taking drugs that provoke miscarriage is allowed for up to 6 weeks. It is the least harmful option for abortion.
  • Vacuum aspiration. The safest option for abortion, which can be performed before 12 weeks of gestation. After 12 weeks, dilation with evacuation of the embryo is practiced. The essence of the procedure lies in the mechanical expansion of the cervical canal and pumping out using a vacuum installation of the fetus. The process takes place under the strict control of ultrasound. This eliminates trauma to the uterus. The woman is under anesthesia during the operation. The duration of the procedure is from 40 minutes to several hours.
  • Curettage. A more traumatic option for removing the fetus from the uterus. It is carried out up to 12 weeks in case of ineffectiveness of taking abortive drugs or vacuum aspiration. Also, curettage can be carried out at a later date, if the gynecologist considers this option productive. The essence of the operation: with the help of a curette (medical instrument), the obstetrician-gynecologist scrapes the upper layer of the uterus, capturing the embryo with it. The method has many disadvantages, including a high probability of damage to the uterus, problems with subsequent conception and bearing.
  • Artificial childbirth. If a woman is more than 22 weeks old, and the fetus weighs more than half a kilogram or has no signs of life, it is advisable to stimulate labor so that the fetus comes out naturally. This eliminates possible complications after interruption by other methods.
  • Hysterotomy. Used in emergencies. A cavity incision of the uterus is performed, followed by extraction of the fetus. After 24 weeks of pregnancy, it is considered a full caesarean section. It is used in cases where other methods have not yielded a positive result.

Legal aspects of medical termination of pregnancy

Performing an abortion for medical reasons is a complicated procedure not only from a medical but also from a legal point of view. The decision to carry out the procedure is made on the basis of the current laws of the Russian Federation. Indications for termination of pregnancy contain an order dated December 3, 2007 with changes as of December 27, 2011.

If a pregnant woman has a confirmed disease that serves as a reason for interruption, the gynecologist convenes a consultation of doctors, at which a full examination of the pregnant woman is carried out. If the pathological processes in the body that are incompatible with the further bearing of the baby are confirmed, an appropriate document with a seal is drawn up. It is he who serves as the basis for the termination of pregnancy.

A woman, according to the law, should be aware of her condition, possible risks in case of refusal to abortion. The pregnant woman must consent to the procedure or deliberately refuse it. Without this, abortion is prohibited. If a woman is in serious condition, permission or refusal to abortion is signed by the next of kin.

Artificial termination of pregnancy - medical indications

The decision to terminate prematurely is taken when the woman's life is in danger or it has been established that the fetus has medical and genetic disorders that, after birth, will lead to lifelong disability.

Medical indications for termination of pregnancy: diseases of a woman

According to the law, abortion for medical reasons is carried out in the presence of the following pathologies:

  • Age up to 15 years.
  • Tuberculosis: all active forms.
  • Rubella: Primary infection in the first trimester.
  • Malignant oncological diseases for the treatment of which chemotherapy or radiation therapy to the pelvic organs is required.
  • Diabetes mellitus: with severe nephropathy, after kidney transplantation, with progressive diabetic retinopathy.
  • Burnet's syndrome in severe and active phase.
  • Acromegaly in the active phase.
  • Prolactinoma (in case of resistance to dopamine agonists and chiasmatic disorders).
  • The active phase of Itsenko-Cushing's syndrome.
  • Primarily diagnosed acute leukemia.
  • Myelodysplastic syndromes.
  • High-risk lymphomas.
  • Hodgkin's disease stage 3-4.
  • Chronic myeloid leukemia: in the terminal stage or requiring therapy with tyrosine kinase inhibitors.
  • Chronic myeloproliferative diseases in the final phase.
  • Severe aplastic anemia.
  • Hemolytic anemia, accompanied by acute hemolytic crises and severe recurrent course.
  • Chronic, constantly recurrent course of Werlhof's disease, which is immune to any type of treatment.
  • Porphyrin disease: an acute attack occurring less than 2 years after the last exacerbation.
  • Mental disorders: chronic and protracted, hereditary and degenerative, caused by taking psychoactive drugs, affective and severe psychogenic disorders.
  • Inflammatory diseases of the central nervous system.
  • Severe course of Huntington's disease.
  • Severe course of Charcot's disease.
  • Severe forms of parkinsonism.
  • Generalized handicaps of dystonia.
  • The progressive course of multiple sclerosis.
  • Severe course of epilepsy.
  • Acute disorders of cerebral and / or spinal circulation.
  • Narcolepsy, catalepsy.
  • Damage to the nerve roots and plexuses.
  • Severe course of Guillain-Barré syndrome.

Important! In case of refusal, the woman takes responsibility for her life, as well as the health of the unborn baby.

List of medical indications for termination of pregnancy: fetal pathology

List of indications for medical interruption for irreparable fetal pathologies:

  • Statement of the intrauterine death of the baby.
  • Detected genetic abnormalities of the fetus.
  • Physical deformities of the fetus, incompatible with life after birth.

When the above abnormalities are detected, a number of additional tests and studies are performed to make sure the diagnosis is correct. After that, the woman is explained the feasibility of an abortion, and with her consent, the pregnancy is terminated.

Social indications for termination of pregnancy

According to the order of the Ministry of Health of the Russian Federation, a woman has the right to independently make a decision to terminate a pregnancy up to 12 weeks of gestation. After this period, she must have valid medical indications, which are documented during the examination.

But there is another reason for interruption - the social factor. So, the decree of the government of the Russian Federation gives a woman the right to consult a doctor for subsequent termination of pregnancy up to 21 weeks in case of conception as a result of rape. In this case, the interruption is carried out within the framework of the state health insurance program.

Late termination of pregnancy: medical indications, contraindications, complications

Late is called an interruption at the 2nd, 3rd trimester of gestation. Indications for abortion are the same as in the early stages - fetal deformities, severe illness of a pregnant woman, incompatible with pregnancy, taking teratogenic drugs, transferring viral infections that disrupt fetal development (rubella), etc.

Late termination of pregnancy for medical reasons may be undesirable due to the woman's contraindications:

  • Rhesus conflict.
  • Blood clotting pathology.
  • Exacerbation of infection of the genitourinary system, including the development of STDs.
  • Long-term corticosteroid therapy.

To make sure that it is safe to carry out an abortion in the 2nd and 3rd trimesters, the woman is carefully examined. It is imperative that an analysis is carried out to determine genital infections, a clinical blood test, biochemistry indicators, an ultrasound scan, a cardiogram. If the cause is a genetic abnormality in the fetus, the amniotic fluid is examined to confirm the diagnosis.

It is known that the earlier the interruption occurs, the less complications there will be. For this reason, late termination for medical reasons is handled with great care. But this does not exclude the risk of developing negative consequences for a woman, namely:

  • damage to the uterus;
  • infection of the uterus and appendages as a result of incomplete extraction of the fetus;
  • endometritis;
  • adhesive process;
  • hormonal dysfunction;
  • endometriosis;
  • secondary infertility.

Important! Given the large list of complications, a future pregnancy after termination for medical reasons may not go as well as we would like. Therefore, pregnant women with a honey abortion in the past should be under the close supervision of a doctor.

How to survive a medically necessary termination of pregnancy

When she has to deliberately abandon the unborn, but already dearly beloved baby, the woman plunges into a state of extreme stress. This is a real test for her and her family. How to cope with this pain of loss and find the strength to live on?

  • To begin with, realize that without a personal desire to survive this, you will not succeed. After all, it is impossible to help a person who does not want it. Open up to your loved ones, accept their support.
  • Now you need to accept the fact that you have agreed to the interruption. You should not blame yourself for anything, because the circumstances with this pregnancy did not depend on you. Finally, accept the fact that it is not your fault for what happened, and forgive yourself. Without this step, all further actions will be in vain.
  • Another effective method will help: try to speak out. A psychologist, girlfriend, husband can listen to you. Above all, do not go to war with memories on your own. It will not hurt to be in comfortable conditions - in a park, in a theater, at a cultural event.
  • Pay special attention to health. Be sure to take a rehabilitation course prescribed by an obstetrician-gynecologist. Also take steps to prevent pregnancy in the next 2-3 months.

Termination of pregnancy for medical reasons - reviews

Most cases of forced termination of pregnancy occur due to the formation of malformations of the baby. Women who have experienced this experience depression, blaming themselves for what happened. Doctors call this condition "post-abortion syndrome." Many women need to correct the psycho-emotional background with the participation of a psychologist, but some cope with the help of loved ones.

As for complications after the procedure, women often note a short-term violation of the hormonal background, which is manifested by an irregular cycle, pathological secretions, and problems with conception. But correctly formulated treatment allows you to normalize reproductive function.

As difficult as it gets, tune in to the positive. Of course, the forced termination of a desired pregnancy is very difficult to survive, but you have another pregnancy and a long-awaited meeting with your baby ahead of you. Therefore, try to come to this moment in good health and good spirits.

Video: Methods of termination of pregnancy for medical reasons