Intrauterine pregnancy is a prerequisite Whether it is an abortion or a medication abortion, there is a prerequisite: a diagnosis of intrauterine pregnancy by B-ultrasound. Timing is the key Within 3 months of pregnancy, abortion and medical abortion can be used to terminate the pregnancy. The timing requirements for medical abortion are more stringent and generally the number of days of menopause (from the first day of the last menstrual period) does not exceed 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 abortion includes negative pressure aspiration and forceps scraping. Negative pressure suction is suitable for those who are within 10 weeks of pregnancy, and forceps scraping is suitable for those who are 10 to 14 weeks of pregnancy. Medication abortion Is medication abortion reliable? Medication abortion is a method of terminating early pregnancy by using medication (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 within 3 days. Indications: Healthy women aged 18-40 years who are diagnosed with normal intrauterine pregnancy, whose number of days of menopause (from the first day of the last menstrual period) does not exceed 49 days, and who voluntarily request the use of medication to terminate pregnancy. ～Women aged between 18 and 40 years old who are healthy and who are at high risk for surgical abortion: abnormalities of the reproductive tract (with the exception of stumpy uterus), severe pelvic deformities, extremely tilted uterus, underdeveloped or firm cervix, scarred uterus, postpartum lactating pregnancy, multiple abortions, etc.; those who are apprehensive or fearful of surgical abortion. Drug abortion should be performed in a medical unit or family planning service institution with emergency conditions, such as emergency scraping, oxygen, fluids, blood transfusion (if there are no blood transfusion conditions, the unit must have near transfer conditions or family planning service institutions at the district or county level), the unit and medical personnel performing drug abortion must obtain a special license 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<95g/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 excitation symptoms; 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. 8. As for Candida vaginitis, it is difficult to cure 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 without 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 medical abortion, and antibiotics can be applied prophylactically so as to facilitate the discharge of meconium, shorten the vaginal bleeding time and reduce the chance of infection. Artificial abortion Is abortion reliable? Abortion is a surgical method to terminate a pregnancy. Depending on the patient's condition, the obstetrician and gynecologist may treat the mycobacteria and perform an abortion after B-ultrasound to clarify a normal intrauterine pregnancy. Indications: Patients who require termination of pregnancy within 10 weeks of gestation without contraindications and who suffer from a serious disease that makes it inadvisable to continue the pregnancy can use negative pressure suction; early pregnancy at ≥10 weeks of gestation should be scraped with forceps. Contraindications: inflammation of the reproductive tract; acute phase of various diseases; poor general condition, unable to tolerate the procedure; body temperature at 37.5°C twice before the procedure. Complications: uterine perforation; comprehensive abortion reaction; incomplete aspiration; missed or empty aspiration; bleeding; postoperative infection; amniotic fluid embolism; cervical laceration; distant complications (such as uterine adhesions, chronic pelvic inflammatory disease, menstrual disorders, secondary infertility), etc. Precautions 1. Correctly discern the size and direction of the uterus, and move gently to reduce injury. 2.Even force when dilating the cervical canal to prevent tearing of the endocervical opening. 3.The uterus that is excessively anteriorly tilted forward or posteriorly tilted backward should be reset first (e.g. the uterus that is anteriorly tilted forward can be pressed downward with the hand on the abdominal wall while the finger in the vagina lifts the cervix upward when doing double consultation), and the operation should be stopped once the probe is bottomless. 4.Strictly abide by the aseptic operation routine. 5, during or after the operation nausea and vomiting, bradycardia, arrhythmia, pale, dizzy, sweating, or even a drop in blood pressure, fainting and other symptoms, should immediately stop the operation, give oxygen, and in severe cases add atropine 0.5-1 mg intravenous injection. 6, after the abortion generally have 7 to 14 days of bleeding time, if the abortion after a long bleeding time or bleeding and the emergence of abdominal pain, abdominal Zhang and other symptoms, should be considered incomplete abortion may, blood or urine hCG test and B-type ultrasound examination can help diagnose. 7.Prohibit sex and bathing within one month after the operation, prohibit heavy physical labor, keep the vulva clean, and follow up after one month when menstruation does not return. 8, because the endometrium of the uterus will be damaged to different degrees during the abortion, premature pregnancy again is likely to cause miscarriage, so patients should promptly implement contraceptive measures after the menstruation, preferably for one year, if there are special circumstances, at least wait for six months before pregnancy. For pregnant women of 10-14 weeks of gestation, they used to be terminated by curettage, but curettage is easy to be complicated by uterine perforation, intraoperative bleeding, exogenous infection, amniotic fluid embolism, abortion syndrome, etc., which brings pain to patients. In recent years, pharmacological abortion supplemented by curettage can reduce the pain of cervical dilation during curettage, reduce the chance of infection and bleeding, shorten the operation time, and reduce the incidence of these complications. Mifepristone antagonizes the action of progesterone, which stops the development of the embryo and separates it from the uterine wall, and also promotes cervical maturation, softening the cervix and making it easy to dilate. Misoprostol enhances the action of prostaglandins, which opens the uterine orifice and promotes contraction of the uterus so that the products of pregnancy are removed and the pregnancy is terminated, and then the uterus is cleared in time to avoid vaginal hemorrhage due to incomplete abortion. However, on the day of misoprostol application, the duration of abdominal pain and vaginal bleeding should be closely observed, and preparations should be made for forceps scraping and fluid and blood transfusion if necessary. It is easier and does not affect the life, study and work on the same day, and the incidence of long-term complications is lower. However, compared to abortion, the success rate of medical abortion is lower, vaginal bleeding is longer and cannot be controlled with medication. If the abortion is incomplete, the uterus must be scraped. Abortion is shorter, has a higher success rate, less post-operative bleeding, faster recovery, and most people can have a successful abortion. However, compared to medical abortion, abortion is more painful, requires rest on the day of the procedure, has surgical risks and corresponding complications, and is more damaging to the body. Effective contraception is the way to go In short, the earlier an unwanted pregnancy is discovered, the better, and the more timely it is handled, the better. However, no matter which abortion method is used, it is only a remedy after the failure of contraception, and effective contraception is the king.