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Although different terminologies are used for the word abortion, such as curettage, abortion, pregnancy termination, pregnancy evacuation, it is actually used to mean the termination of unwanted pregnancies. Unfortunately, one in every four women has to have an abortion during their reproductive life.
Our patients who want to receive verbal information about the abortion process can get information from our clinic’s phone number 0533 049 66 87.
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Our patients who want to obtain information about the abortion procedure from the written text can read my informative article about the abortion procedure in detail below.
According to the Family Planning Law, which came into force in our country on May 24, 1983, unwanted pregnancies occur on the 10th day of the last menstrual period. It can optionally be terminated up to the gestational age.
Even though it is legal to have an abortion, I will still include information about abortion in the rest of my article in order to clarify some situations. However, deciding to terminate a pregnancy is an important decision. I recommend that couples or women reconsider their decision before abortion. I ensure that our patients who have decided to have an abortion undergo this procedure in line with their decision, in a hygienic and sterile environment, with years of experience.
What is Abortion? How To?
Abortion; It is the name given to the process of scraping the inside of the uterus with metal tools called curettes. Abortion can be performed not only to terminate pregnancy but also for endometrium biopsy and probe curettage (uterine biopsy) when there is no pregnancy. With the development of modern medicine, pregnancy terminations are now performed by vacuum aspiration, although the name remains abortion or curettage. The vacuum aspiration model is a safer and less risky procedure than the scraping method. Vacuum aspiration is the vacuuming of the pregnancy material inside the uterus with large syringes.
Situations Where Abortion May Be Performed
- Unintended pregnancies
- Stop of development in the baby
- The baby has a disability incompatible with life
- Situations in which pregnancy must be terminated medically; radiation, drug exposure, etc.
- Uterine cancer suspicion
- Increased uterine wall thickness
- Irregular bleeding
- Post-menopausal bleeding
How is Abortion Performed?
In the past, abortion was performed with metal surgical instruments called curettes. These metal curettes were risky because they could rupture the uterus and create intrauterine adhesions.
Nowadays, this method has been almost completely abandoned for terminations of pregnancies under 10 weeks. This method, that is, the use of iron curettes, is rarely used in pregnancy terminations between 10-20 weeks of pregnancy due to medical necessity (heart failure of the baby in the womb, disability, situations incompatible with life, requiring evacuation, etc.).
How is Vacuum Abortion Performed?
- The patient is placed on the gynecological table and the cervix is observed with a disposable sterile speculum.
- The vagina and cervix are wiped with an antiseptic solution to minimize the risk of infection.
- The plastic cannulas are then passed through the cervix and reach the inside of the uterus.
- A large syringe that acts as a vacuum is connected to the outer end of the plastic cannula and the materials inside the uterus are aspirated. For these procedures, cannulas with a diameter of 5 or 6 mm are usually sufficient.
- These cannulas are disposable and disposable.
- Performing this procedure under ultrasound guidance minimizes the possibility of fragments remaining in the uterus.
- After the procedure is completed, the cervix is checked.
- The abortion process takes approximately 5-10 minutes.
The biggest reason that prolongs the procedure time is that these thin cannulas do not pass through the cervix. Although this condition is not very common, it is most common in women who have given birth by cesarean section or have never given birth. In this case, the cervix should be carefully dilated up to 5-6 mm with thin plugs. However, the physician should pay close attention to this part. Because uterine perforation most often occurs during the cervical dilation process with a bougie.
Vacuum curettage has advantages such as less possibility of intrauterine adhesion, less bleeding, less pain, less risk of uterine perforation, and earlier return to normal life.
Is Anesthesia Required During Abortion?
Vacuum curettage is a painful procedure. Although some women can have this procedure done without anesthesia, it is more suitable for patient comfort to have this procedure done under local or general anesthesia. After the procedure, a pain similar to menstrual pain may continue for a few hours. Local anesthesia is also very effective in relieving pain during abortion. The patient can have an abortion quite comfortably under sedation, where a lower dose of medication is given compared to general anesthesia.
What needs to be taken into consideration here is that if the patient is going to have an abortion with sedation, they should not eat anything 4-6 hours before the procedure. It is very important that the procedure be performed under the supervision of a good anesthesiologist. After sedation, the patient regains consciousness within a few minutes.
In the abortion procedure with local anesthesia, local anesthetic material is administered to the cervix. Therefore, there is no complete numbness and pain in the uterus may be felt. In this case, conditions such as the patient’s pain threshold, taking a painkiller half an hour before the procedure, and whether she has had a normal birth before will determine the severity of the patient’s pain. It seems more logical for people who have never had a normal birth before to have this procedure with sedation.
Situations to Consider Before Abortion
Before the abortion procedure, it must be determined that the pregnancy is inside the uterus by ultrasound. If pregnancy is not seen on ultrasound, a blood pregnancy test called b-hcg should be performed. If this value is high and a gestational sac is not observed in the uterus, the patient should be evaluated carefully as there may be a possibility of ectopic pregnancy.
If a gestational sac is seen in the uterus, the other important thing is to confirm the gestational age. Pregnancy week is confirmed by ultrasound and the woman’s last menstrual period. Abortion can be performed on women who have a gestational sac inside the uterus and who are less than 10 weeks pregnant.
However, in this case, the most important parameter is the woman’s blood group. If the woman’s blood type is Rh negative, the woman must learn the blood type of her husband or partner. If the woman is Rh negative and the man is Rh positive, there is blood incompatibility. In this case, Anti-D immunoglobulin (blood incompatibility injection) must be administered within 72 hours so that the woman’s other pregnancies are not adversely affected.
Another important situation is that if the pregnant woman will have an abortion with sedation similar to general anesthesia, the procedure must be accompanied by an anesthesiologist and the woman must not eat or drink anything for 4-6 hours before the procedure.
Apart from these, if the patient has a chronic disease or allergy, it is necessary to share this information with the doctor before the abortion procedure.
What are the Situations to Be Considered After the Abortion Procedure?
After the abortion procedure, that is, after the vacuum abortion procedure, the patient rests for approximately 10 to 20 minutes. During this period, one may experience mild groin pain and mild nausea, dizziness and light-headedness due to anesthesia. These conditions pass within 1-1.5 hours and the patient can return to normal life. He can eat and drink whatever he wants. Driving is not recommended only during these few hours. If possible, there should be a person next to the patient who comes for the abortion procedure and should support her.
After the abortion procedure, antibiotics and painkillers are usually prescribed. Antibiotics should be used for 5 to 7 days, painkillers should be taken every 12 hours, especially on the first day, and should be used in the following period when the patient has pain.
It is normal to have spotting, no bleeding, or less bleeding than menstrual period after the abortion procedure. But having more menstrual cycles is an unexpected situation after the abortion procedure. In this case, you should definitely consult your doctor.
The possibility of infection after the abortion procedure is rare if sterile conditions and hygiene are observed. However, foul-smelling vaginal discharge, persistent groin pain and fever after an abortion are not normal. In case of such situations, it is necessary to consult a doctor.
Sexual intercourse is not recommended for the first 10 days after the abortion procedure. Earlier sexual intercourse increases the chance of infection.
You can take a bath or shower the same day after the abortion procedure. There is no need for any procedure such as dressing etc. However, the inside of the vagina should never be washed with water. This increases the risk of infection after abortion.
An ultrasound check should be performed one week after the abortion procedure. Remaining a piece in the uterus is a rare situation if the abortion procedure is performed under ultrasonography guidance. However, every possibility should be taken into consideration and patients should not neglect control.
Stay healthy..
Prof. Dr. H. Onur Topçu
Gynecology & Birth-In Vitro Fertilization and Advanced Gynecological Endoscopy Specialist
PATIENT COMMENTS
Der Lehrer von Onur war in jeder Phase des Prozesses, vom Anfang bis nach der Operation, sehr unterstützend und ermutigend. Er hat uns auf die beste und genaueste Art und Weise informiert, indem er alle Details des Prozesses vollständig und klar erklärt hat. Ich möchte meinem Lehrer Onur sehr danken und ihn auf jeden Fall denjenigen empfehlen, die einen Arzt auf diesem Gebiet suchen.
Arz*** A***
