Intrauterine pregnancy is a prerequisite
Whether it is an abortion or a medical abortion, there is one prerequisite: an intrauterine pregnancy confirmed by ultrasound.
Timing is the key
Both abortion and medical abortion can be used to terminate pregnancy within 3 months of pregnancy. The time requirement for medical abortion is more stringent and the number of days of menopause (from the first day of the last menstrual period) is usually not more than 49 days. The main reason is that if the embryo is too large, it will increase the chance of failure of medical abortion, and if the larger embryo cannot be completely eliminated, it will easily get stuck in the uterine opening and cause heavy bleeding. Surgical abortions include negative pressure aspiration and curettage. Negative pressure aspiration is suitable for those who are within 10 weeks of pregnancy, and forceps scraping is suitable for those who are between 10 and 14 weeks of pregnancy.
Medication abortion
Medication abortion is a method of terminating early pregnancy using medications (such as mifepristone, misoprostol, etc.). Currently, the dosage of mifepristone is 150-200 mg, which can be taken in a single dose or in parts over 3 days. 600 mg of misoprostol should be taken orally on the morning of the third day, one hour after taking mifepristone on an empty stomach or one hour after taking mifepristone.
Indications: Healthy women aged 18 to 40 years who are diagnosed with normal intrauterine pregnancy, with days of menopause (counted from the first day of the last menstrual period) not exceeding 49 days, and who voluntarily request the use of drugs to terminate pregnancy; high-risk candidates for surgical abortion: genital tract abnormalities (with the exception of stumpy uterus), severe pelvic abnormalities, extreme tilting of the uterus, cervical hypoplasia or firmness, scarred uterus, postpartum lactating pregnancy, multiple abortions, etc. The patient who has apprehension or fear of surgical abortion.
Drug abortion should be performed in units with rescue conditions, such as emergency scraping, oxygen, fluids, blood transfusion (such as units without blood transfusion conditions must have near transfer conditions of medical units or family planning services at the district or county level or above), the implementation of drug abortion units and medical personnel, must obtain special permission to practice in accordance with the law before proceeding.
Contraindications.
Mifepristone contraindications (adrenal disorders, diabetes and other endocrine disorders, abnormal liver and kidney function, history of pruritus during pregnancy, history of blood disorders and vascular embolism, tumors related to steroid hormones); prostaglandins contraindications: cardiovascular system diseases, hypertension, hypotension, glaucoma, gastrointestinal disorders, asthma, epilepsy, etc.; allergies; pregnancy with apparatus; ectopic pregnancy or suspected ectopic pregnancy; anemia (Hb<95 g/L); severe pregnancy vomiting; long-term use of the following drugs: rifampin, isoniazid, antiepileptics, antidepressants, cimetidine, prostaglandin biosynthesis inhibitors (aspirin, etc.), barbiturates; smoking more than 10 cigarettes/day or alcohol abuse.
Complications: vaginal bleeding; gastrointestinal reactions; menstrual disorders; vagal excitement; incomplete abortion; infection; weakness, flushing, etc.
Precautions
1. The medication must be taken on time, no missed doses, no concurrent use of anti-inflammatory pain, salicylic acid, sedatives and broad-spectrum antibacterial agents during the medication period.
2.Follow up on schedule.
3.After the start of vaginal bleeding, the user should use a special commode or disposable cup at the vaginal opening to observe whether there is any tissue elimination. If any tissue is discharged, it should be sent to the original clinic for examination in time.
4. If you still have vaginal bleeding 3 weeks after the expulsion of the embryo sac, you should seek medical consultation.
5.If there is sudden and heavy active vaginal bleeding, persistent abdominal pain or fever, prompt medical consultation is required.
6.After medical abortion, sexual intercourse should be forbidden before menstruation, and contraceptive measures should be implemented in time after menstruation.
7, medical staff should always pay attention to the identification of ectopic pregnancy, staphyloma and chorioepithelial carcinoma in the process of drug abortion to prevent missed diagnosis.
As for Candida vaginitis, it is difficult to be cured during pregnancy, but it can be controlled by local medication before the operation. Besides, Candida mainly adheres to the mucous membrane and rarely infects upstream in the absence of vaginal surgery. Patients must be reminded to pay attention to the vaginal bleeding, if there is tissue discharge should be promptly consulted.
9. It is better to rest for two weeks after the medical abortion, and antibiotics can be applied prophylactically, which will facilitate the discharge of meconium, shorten the vaginal bleeding time and reduce the chance of infection.