Abortion - Ota Jinemed Hospital

What is an abortion?

It is a surgical intervention performed to terminate an unwanted pregnancy among the public. Unwanted pregnancies, defined as accidents, may occur in the life of a woman who has been out of wedlock, sometimes restricting your academic career, or in a recently finished marriage. In other words, pregnancy can cause problems in your social life. Unwanted pregnancies that can happen to every couple can only be terminated by abortion.

After the pregnancy occurs, the practices known as abortion medication and injections in the society cause a waste of time. Abortion is a legal intervention that is limited by some laws in our country, in many states of America and in most European countries. This legal process actually protects the woman and the female body. In our country, legal termination of pregnancy with a duration of up to 10 weeks, the consent of the spouse if the woman is married, and the 18 age limit if the single is sought. Especially the legal process up to 10 weeks protects the female body. Because as the pregnancy progresses, the risks brought by the procedure increase. While making this decision, women should be informed in detail by their physicians and should always be advised to make a decision together with their partners. Before the abortion procedure, the woman should be given a decision-making period and 2 interviews should be made at least 1 week apart.

What kind of procedure is abortion? How is it done?

Generally, the appropriate time is between 5-7 weeks and the procedure becomes more difficult as the pregnancy progresses. Both general anesthesia and local anesthesia (only numbing the cervix) can be performed. However, before abortion, blood count, blood type, coagulation tests should be performed on every woman. It should be evaluated especially in terms of blood incompatibility, if there is blood incompatibility, a protective needle should be applied after the procedure. The presence of a genital infection should be investigated in the patient to be treated, and antibiotics should be given when necessary. Our recommendation is to perform the procedure in the hospital in the presence of an anesthesiologist. The operation takes about 10 minutes and the patient is discharged on the same day. In modern gynecology, pregnancy termination is applied with the negative pressure formed in the uterus called vacuum curettage. During this process, negative pressure is created with the cannulas attached to the large plastic injector tip.

Plastic cannulas are disposable and reduce the risk of infection and damage to the uterus. There is usually no severe pain or bleeding after the procedure. There may be pain similar to menstrual pain. And simple pain killers are used. Sometimes there may be spot type vaginal bleeding that lasts for 15-20 days. The first menstruation after abortion occurs 4-6 weeks after the procedure. In rare cases, problems such as infection, uterine perforation, remaining parts in the uterus, intrauterine adhesions, and unsuccessful abortion may be encountered after abortion. For this reason, abortion should be performed by specialist obstetricians in a full-fledged hospital where all kinds of emergency interventions can be performed.

As a physician and a woman, I always recommend abortion under general anesthesia. Because the decision of abortion often shakes the woman psychologically, the woman’s consciousness and feeling pain during this procedure create a trauma effect on the life of the woman. In order to minimize this trauma, the procedure should be done in painless and sterile conditions. Although complications are very rare after careful and meticulous procedures, every woman should be informed about this before the intervention.

Abortion Duration

The operation takes 5-8 minutes on average and the patient is kept under observation for 2-3 hours after the intervention, and is called for control after 1 week. After the intervention, a spiral (intrauterine device) can be inserted at the request of the patient. Thus, protection is provided in the next period.

Vacuum Curettage

The medical world is always in search of surgical methods that have the lowest complications, do not harm the patient, and give good results. Making an abortion decision is one of the most difficult times in every woman’s life. And every woman wants the intervention not to harm her body. For this purpose, the important factors that women who start the research should pay attention to are that the procedure is performed under sterile conditions, with a disposable carmine cannula (you can think of it as a thick and hard pipette) in a safe environment, that is, in hospital conditions, in the presence of an anesthesiologist. Karmen cannulas are in different sizes. Different sized cannulae are used according to the week of pregnancy. First of all, a light anesthesia is provided to the patient, who is taken to the gynecological table, by administering the necessary medications via vascular access. Then a device called a speculum is inserted into the vagina. It is washed with a suitable solution to ensure cervical and intravaginal disinfection. Carmen cannulae are then inserted into the uterus. The pregnancy material in the uterus is evacuated with the effect of negative pressure through injector-like apparatus attached to the cannulas. After the intervention, the uterus is checked by ultrasonography. The procedure is terminated after it is observed that the inside of the uterus is completely cleaned and the bleeding is controlled. Pain killer is applied to the patient to avoid pain after the procedure. The patient can be discharged after 2-3 hours of follow-up after the intervention, and after a day of rest, she returns to her normal life.

Tests Before Abortion

Every surgical intervention, whether it is short or long, should be evaluated in detail. The presence of chronic disease should be investigated. Blood values, blood type, bleeding and clotting time should be checked in every woman.

Blood Conflict in Abortion

In couples with blood incompatibility, it is mandatory to have a blood incompatibility injection after abortion. If the woman’s blood type is Rh (-) negative and the same blood type is RH (+), it indicates blood incompatibility. In this case, a blood incompatibility injection is made.

Post-Abortion Conditions

There may be less vaginal bleeding than menstrual bleeding that lasts 6-7 days after abortion. Since it is usually controlled by ultrasonography after the procedure, we do not frequently encounter the so-called part remaining after abortion. However, women who have heavy vaginal bleeding after abortion should definitely consult their physician. For this reason, it is important for your safety to reach your doctor at any time. You are expected to have a period approximately 30-35 days after the abortion. In other words, it is normal to have a delay of 7-10 days and there is nothing to worry about. However, if you have not had periods despite the passage of this period, you should definitely consult your doctor. After abortion, in rare cases, menstruation may not occur due to the damage and adhesion of the inner wall of the uterus. Such a complication is usually not encountered after the curettage procedure performed with the vacuum curettage method. It is enough to rest at home for 1 day after abortion and you may have mild menstrual pain. It is very useful to use painkillers recommended by your physician to prevent this pain. After the intervention, it is not recommended to take your shower standing, especially in the first 15 days, to swim in the sea, the pool, and to use vaginal tampons. It is among our prohibitions on the first 10 days of sexual intercourse.

Post-Abortion Control

Every woman should be informed to apply immediately in case of symptoms such as bleeding, fever, abdominal pain, vaginal discharge after abortion. Apart from these, every woman should be called for a control one week after the intervention.

Post-Abortion Menstruation

Menstruation occurs on average 30-35 days after the abortion. Some women may have vaginal bleeding that lasts up to 20 days after an abortion. This bleeding may be less than menstrual bleeding, or it may continue intermittently. It is a normal condition, and it is useful to explain this situation to your physician during the 1st week control after the procedure. If there is no bleeding in the uterus, pieces or clots during the control, there is no need for additional intervention in the ongoing vaginal bleeding.

Abortion Complications

Abortion is a surgical intervention and not a birth control method. As with any surgical intervention, there are a number of complications in abortion. These risks are generally not seen in the interventions made in the first 10 weeks, which is the legal limit.

In today’s conditions, complications are rare since the abortion procedure is performed under sterile conditions with the use of appropriate antibiotics and vacuum curettage.

1-bleeding: There may be a small amount of bleeding after the intervention. However, the amount of bleeding that occurs in the legal abortion procedure performed before the 10th week is very low and mostly does not pose a risk. If bleeding exceeds 20 days and is accompanied by pain, you should immediately consult your doctor. This may be caused by infections or remaining intrauterine parts.

2-infection: Due to the development of abortion techniques and the operation being performed under sterile conditions, infection is not a common situation. Although it is a rare complication, it should be followed carefully and closely because it causes uterine and ovarian inflammation. In case of doubt, it should be treated with appropriate antibiotics. After abortion, every woman should be warned of the symptoms of fever, vaginal discharge, and severe abdominal pain. In case of these symptoms, he should be informed about the emergency application.

3-uterine perforation: It is a rare complication and can cause serious problems if not noticed on time. Especially in cases where the uterus is structurally inclined excessively forward or backward, the risk of perforation of the uterus is high and the intervention performed under ultrasound supervision reduces this risk.

4-piece retention (rest placenta): part may remain in the uterus after abortion. As it can be detected when checked by ultrasonography, the patient can apply with ongoing vaginal bleeding. In some cases, a second intervention may be required. The second intervention takes a shorter time and any ongoing vaginal bleeding is stopped.

5- unsuccessful abortion: failure to perform abortion, the continuation of pregnancy despite the intervention. Especially when the pregnancy test is positive, but in the early weeks, it can be during abortion in cases where the pouch is not seen in the uterus. In order to avoid this problem, the abortion can be performed after the ultrasonography is seen in the uterus and the control with ultrasonography immediately after the procedure can prevent this situation. Every woman should definitely be called for a check-up after an abortion. If it is seen that the pregnancy continues when he is called for control, the second intervention is planned.

6-adhesion in the uterus (Asherman’s syndrome): usually presents with inability to menstruate after abortion. With the use of vacuum technique in abortions, its frequency has decreased. Despite all the precautions, in case of intrauterine adhesions, a camera is entered into the uterus called hysteroscopy and the existing adhesions are opened.

Abortion and Marriage

Marriage is not compulsory to have an abortion. Unmarried women over the age of 18 can have an abortion of their own free will. In married couples, before the intervention, the spouse must give consent to the intervention.

Pregnancy Prevention After Abortion

Every woman should be consulted by the obstetrician about prevention methods after abortion and the most appropriate method should be chosen for the patient. The aim is to prevent unwanted pregnancies that lead to abortion. It can be worn right after the spiral procedure after abortion. Birth control drugs can be started after abortion. Patient’s request, chronic diseases, medications used, number of births, and age are important in choosing the method.

Post-Abortion Infertility

Curettage is a surgical intervention, and if it is performed in appropriate conditions and in appropriate weeks, an uncomplicated recovery process is passed. There may be a new pregnancy after an abortion. abortion does not lead to infertility. However, the uterus may be damaged due to some complications after abortion. Pregnancy may be difficult due to intrauterine adhesion.

Miscarriage Pills

The use of such drugs outside the hospital without the doctor’s permission is very dangerous. It may cause severe bleeding. The sale of these drugs in our country is prohibited.

Abortion Price

As with any surgical intervention, abortion is determined according to the pricing determined by the Turkish Medical Association. However, there may be price differences depending on the hospital where the abortion procedure will be performed, the anesthesia applied and the week of gestation. You can get information from your doctor about this before the operation. Different hospitals may have different prices. The important thing is that this procedure is performed under sterile conditions and in a clinic where all complications can be treated. Not all hospitals and obstetricians can perform abortions.

Where Are Abortion Procedures Done?

The abortion procedure, which is defined as minor intervention, is recommended to be performed in the hospital considering all kinds of complications. However, it can also be done in clinics that have the necessary conditions.

RECOMMENDATIONS FOR WOMEN HAVING CURETAGE PROCEDURE

1-There are some risks associated with every surgical procedure. Complications have decreased with the vacuum curettage method, which has been applied more frequently in recent years. In addition, pregnancies greater than 10 weeks cannot be terminated unless there is a medical requirement. Despite all these precautions, some complications after abortion can be seen, albeit rarely. Every woman who decides on an abortion procedure should be informed about the risks.

2-Both local and general anesthesia can be used during the curettage procedure. The procedure we recommend is to be performed under general anesthesia, painlessly and under sterile conditions. So general anesthesia is suitable for this intervention. Because for some women, remembering this moment can be lifelong pain. It can cause psychological problems. Therefore, fasting for 6-8 hours before the intervention is recommended for women who will receive general anesthesia.

3- If the cervix is extremely hard, it may not be possible to enter into the uterus and pregnancy may not be evacuated, especially in abortion that has not had a pregnancy before and is performed without monitoring the gestational sac. In this case, the intervention can be delayed for 5-7 days. After monitoring the gestational sac in the uterus, an intervention should be performed.

4- Post abortion pain may be mild like menstrual pain. However, in case of severe pain, heavy bleeding and fever, consult your physician immediately.

5- If possible, rest for 4-6 hours after abortion. Do not think about the process and what has been done. Do not believe the wrong ideas that I will not have a child again. The important thing is that you apply protection methods and never experience the same problem again.

6- The most important point in injury and perforation in the uterus, which is the most important complication that may occur after abortion, is to notice this and to follow the patient. Patients with stable follow-up findings are usually sent home to be called for follow-up after 24 hours of follow-up.

7-After 1 week after abortion, you should definitely go to the control and decide on the birth control method together with your doctor.

8-After abortion, your period may be 30-35 days later. Do not worry about bleeding until your menstrual period. But especially in the first 15 days when open to infection, you should not enter the sea, pool, do not take a vaginal shower, and the prohibition of intercourse are the rules to be followed.

9-In couples with blood incompatibility after abortion, a blood incompatibility injection should be made. The injection should be applied within the first 72 hours. (Blood incompatibility refers to the condition that the woman’s blood type is rh (-) negative and the male is rh (+) positive. Since we do not know the blood type of the fetus, women who have had an abortion should be injected in case of blood incompatibility.