After six years of marriage without a baby, 32-year-old Ms. Zhang and her husband went to the fertility center for consultation, eager to help her conceive through assisted reproductive technology. She told the doctor about her two miscarriages: one accidental pregnancy when she was 20 years old, and another “hit” after taking the emergency contraceptive pill in the same year. “She was still a student at the time and didn’t know anything about it, so she had an abortion and didn’t feel anything but pain, but now she can’t get pregnant. Thinking about her rashness and naivety at that time, Ms. Zhang regrets.
In China, like Ms. Zhang, there are many women who choose abortion as a “solution” to their unwanted pregnancy. According to the World Health Organization, 48 million abortions are performed each year worldwide, and China ranks first in the world with at least 13 million cases each year. More than half of them are women under the age of 25, 65% are unmarried women, 54.3% are unwanted pregnancies due to the failure to take any contraceptive measures, and up to 50% are repeat abortions.
The term abortion has become a household word in our society, which is the artificial termination of pregnancy. Today, with the development of science and technology, the technology of termination of pregnancy has become very mature – easy to perform, short and inexpensive. Especially after the emergence of “painless abortion”, many public places are filled with a variety of small advertisements – “safe to preserve the uterus, does not affect the second pregnancy”, “keep the property rights, abort the accident”. The company’s main goal is to provide a safe and secure environment for the customers. The alluring solicitations of these businesses make this originally hideous process wear a veneer of ease and gentleness.
Painless abortion is the use of intravenous anesthesia to make the patient feel no pain during the procedure, but is “painless” really the same as “zero harm”? Can abortion really be as easy as a dream in three minutes, as advertised? Let’s understand some basic knowledge of abortion and see what truths are hidden in these magnificent bubbles.
A. What are the methods of early pregnancy termination?
1, drug abortion.
For pregnancy within 7 weeks from the first day of the last menstrual period. The commonly used drugs are mifepristone and misoprostol. The former causes degeneration and necrosis of the uterine metaplasm and softening of the cervix, while the latter induces contraction of the uterus, leading to the expulsion of the embryo.
2. Negative pressure aspiration of the uterus.
Negative is indicated for pregnancies up to 10 weeks. In layman’s terms, when the gestational sac and embryo are relatively small and the placenta has not yet formed, the pregnancy is sucked out of the uterine cavity by negative pressure.
3. Clamp scraping.
It is suitable for pregnancies from 10 to 14 weeks. Because the fetus grows gradually and even the bones are formed, the pregnancy tissue cannot be sucked out by negative pressure alone. In this case, the placenta and fetal limbs need to be removed in pieces after the clamp.
Second, what are the complications of abortion? What harm will it bring to women?
1. Complications during the operation.
① Bleeding: If the bleeding exceeds 200ml, it is called bleeding during abortion. Most of the reasons for bleeding are due to the large pregnancy month, part of the pregnancy tissue can not be removed and caused by poor contraction of the uterus. Severe cases even cause hemorrhagic shock.
② Uterine perforation: As the name implies, it refers to the uterus breaking during the procedure. Excessive uterine tilt and flexion, repeated multiple abortions, and scarred uterus are high-risk factors for uterine perforation.
(iii) Leakage and empty aspiration: Leakage is the failure to aspirate embryonic tissue, resulting in continued development of the pregnancy. Empty aspiration is when a non-pregnant uterus is mistaken for a pregnant uterus and abortion aspiration is performed.
④Abortion syndrome: It means that the recipient develops bradycardia, arrhythmia, decreased blood pressure or even fainting and convulsions during the procedure.
⑤ Amniotic fluid embolism: After rupture of membranes, amniotic fluid enters the blood circulation through the cervical fissure or the open blood sinus of the uterine wall, and amniotic fluid embolism can occur. It is more likely to occur during the clamp scraping procedure.
2, recent complications.
(1) Incomplete abortion: some of the pregnancy remains in the uterus, which is manifested by continuous vaginal bleeding for more than 2 weeks. It is most likely to occur during medication abortion.
②Infection: often occurs when there is genital inflammation before the operation or when the aseptic technique is not strict during the operation. In addition, residual pregnancy material is also prone to complicate infection.
③Uterine adhesions: excessive scraping of the uterine cavity during surgery, excessive negative pressure during suction, scraping off the basal layer of the endometrium, scarring of the endometrium during repair, and formation of uterine adhesions.
3.Distant complications.
①Chronic pelvic inflammatory disease: the infection after abortion is not effectively treated and easily develops into chronic pelvic inflammatory disease.
Secondary infertility: pelvic inflammatory disease and uterine adhesions affect the function of the uterus and fallopian tubes and the pelvic environment, and these irreversible damages can directly lead to infertility.
③Endometriosis: Repeated intrauterine operations cause medically induced endometriotic implantation.
④Menstrual irregularities
4. Complications during re-pregnancy.
The incidence of antepartum hemorrhage, preeclampsia, placenta praevia is significantly higher, and the incidence of placental adhesions and placental implantation is also increased during full-term delivery.
How to deal with common complications?
1. Bleeding.
If bleeding occurs during abortion, the cause of bleeding should be found immediately and treated symptomatically at the same time. The main purpose is to quickly remove the residual pregnancy in the uterine cavity and strengthen the contraction of the uterus. If the bleeding is caused by uterine injury, it should be treated according to uterine perforation.
2. Leakage and empty aspiration.
If no villi are seen in the aspirated tissue, the aspirate should be sent for pathological examination, and if necessary, blood HCG and ultrasound should be repeated to exclude ectopic pregnancy. If intrauterine pregnancy is confirmed and the pregnancy tissue is not aspirated, another abortion should be performed and antibiotics should be used to prevent infection.
3. Uterine perforation.
Depending on the site of perforation, size, whether the pregnancy material is removed, fertility requirements and other specific circumstances, choose to use conservative treatment, uterine repair or hysterectomy and other treatments.
4, abortion syndrome.
Once the abortion syndrome occurs during the operation, the operation should be stopped immediately, changed to lateral position, and atropine injected intramuscularly or intravenously. Wait for improvement and then complete the operation.
5.Incomplete abortion.
If there is more bleeding after the operation, the uterus should be scraped immediately, and antibiotics and contractions should be given after the operation. If there is not much study, antibiotics can be used for 2-3 days before scraping the uterus.
6. Uterine adhesions.
Hysteroscopy is the best means of diagnosis and treatment. After using hysteroscopy to loosen adhesions, stents can be placed in the uterine cavity for 3-6 months and removed, while estrogen and progesterone cycles are given for 2-3 cycles to promote endometrial growth.
7. Distant complications.
It is relatively difficult to deal with and the effect is not very satisfactory, the key lies in prevention.
From the above introduction, we can see that no matter which abortion method, it will bring harm to women. As for painless abortion, it is only because of the general anesthesia during the operation, so that patients are free from the pain of intraoperative scraping, but the damage to the body is no less! Some people ask, how many abortions can a woman bear at most before pregnancy? As obstetricians and gynecologists, we would like to say that it is better not to have one at all! The damage caused by abortion cannot be measured in terms of “quantity”, but rather the “quality” of the impact. Some can be repaired, some cannot be reversed. When you are seeking medical help for your current infertility, have you ever thought that it is to pay for the ignorance and rashness of the year!
Every little life is a gift from God. It grows in your warm womb, from a single cell, into a tiny embryo. Even though it is only a few weeks in size, it has a heartbeat and a limb bud. If you have seen these tiny embryos under ultrasound, watched them shake their heads and hips and twist their buds, can you bear to remove them from your body and expel them from your life? The abortion is not only killing a little life, but also your right to be a mother!
In fact, the trauma of abortion can be completely avoided. With proper contraception, the risk of unwanted pregnancy can be greatly reduced. Here, we urge all women to be cautious about abortion and take responsibility for their present and future!