Artificial termination of pregnancy in medicine is called vacuum aspiration or mini-abortion. Vacuum aspiration began to be practiced in the 60s of the last century and to this day it is successfully practiced in clinics and gynecological departments.
A mini-abortion is performed at 5-6 weeks by suctioning out the fertilized egg by creating negative pressure. Thanks to vacuum aspiration, it was possible to significantly reduce damage to the uterus, infections, and bleeding.
The popularity of vacuum aspiration is explained by the ability to carry out the procedure on an outpatient basis using simple medical equipment, without general anesthesia, because the procedure is practically painless.
Until what period can a vacuum abortion be performed?
When contacting a gynecologist with a request for a mini-abortion, the gynecologist is first of all interested in the number of days of delay in menstruation (that is, the number of days during which menstruation did not occur).
A mini-abortion can be performed only if there is a delay of up to 21 days, but the best option is to carry out the procedure on the 14-15th day of absence of menstruation, since when performing vacuum aspiration before two weeks there is a risk of not noticing the fertilized egg and removing it.
To have surgery later increases the risk of complications.
Complications
more about all types of complications after artificial termination of pregnancy in a separate article.
- Incomplete abortion is a common complication of abortion using vacuum aspiration. It occurs when the fertilized egg is not completely removed from the uterus. This can lead to the development of serious inflammation and require surgical intervention. To prevent incomplete abortion, it is necessary to carry out the procedure under ultrasound control.
- After an abortion, the risk of developing hormonal disorders increases - an endocrine factor in infertility in the future.
- The addition of inflammation and infection often occurs after abortion, since the uterine cavity is injured and vulnerable.
Despite the fact that the vacuum abortion procedure is quite low-traumatic (especially mini-abortion for up to 5 weeks), we should not forget that this is a third-party intervention in a woman’s body, which cannot be called completely safe.
Indications for mini-abortion
There are no special indications for a mini-abortion; the leading and sufficient indication is the woman’s desire to terminate the pregnancy. But there are also medical indications for early termination of pregnancy. Vacuum aspiration is indicated:
- during frozen pregnancy;
- with anembryonia;
- if bearing a fetus poses a threat to a woman’s health and life (diabetes mellitus, severe liver and kidney pathologies, malignant tumors, etc.);
- with rubella, influenza and other infections during pregnancy;
- social indications (for rape, being in prison, etc.);
- if necessary, endometrial biopsy;
- if remnants of the fertilized egg are found in the uterus after a pharmacological or surgical abortion;
- when parts of the placenta are retained after childbirth or cesarean section;
- for menstrual irregularities (bleeding);
- with accumulation of blood (hematometra) or serous fluid (serozometra) in the uterine cavity;
- with incomplete spontaneous abortion.
Medical termination of pregnancy
One of the many methods of terminating pregnancy, which is also practiced in the early stages, is medical abortion. The advantages of this particular option are that abortion occurs due to the use of special medications. No surgery required.
The period during which such a mini-abortion is performed should not exceed four weeks. At this stage, hormonal changes in the body are just beginning and the fertilized egg itself does not have time to properly attach to the wall of the uterus. The procedure must be carried out under the guidance of a qualified specialist in the clinic. This requires preparation and has contraindications.
The preparatory stage for almost all types of abortion is identical; it involves a series of tests and an examination by a gynecologist. A detailed conversation is also held in which all the features of the procedure and the effect of the drugs are explained.
Contraindications to medical abortion are factors such as:
- Individual intolerance to devices.
- Any inflammatory disease of the female genital organs.
- Uterine fibroids.
- Extragenous pathology.
- Adrenal insufficiency.
Experts also include women with a bleeding disorder, a negative Rh factor in their blood, and women with sexually transmitted infections at risk.
Contraindications for the procedure
Vacuum aspiration or mini-abortion belongs to the group of invasive interventions; in fact, it is a minor surgical operation. Therefore, a mini-abortion has contraindications, as does surgical termination of pregnancy.
Gynecologists call contraindications to vacuum aspiration:
- ectopic pregnancy;
- fever;
- infectious processes of any localization (including “colds” on the lips - herpes);
- acute chronic diseases of organs located in the pelvis or their exacerbation;
- blood clotting disorder;
- less than six months after the previous termination of pregnancy.
Mini-abortion is not performed due to specific contraindications:
- when the pregnancy is more than 5 weeks (according to ultrasound readings);
- with malformations of the uterus;
- for tumors of the uterus, due to which its cavity is deformed.
Necessary tests
- To confirm intrauterine pregnancy, blood is donated to determine hCG, a hormone that increases hundreds of times during pregnancy.
- Then an ultrasound examination (ultrasound) is performed, which determines the position of the fertilized egg and thereby excludes ectopic pregnancy.
- Next, a smear is taken to determine the degree of cleanliness of the vagina. If inflammation is detected, vaginal sanitation is required - treatment with antiseptic drugs.
- General blood and urine analysis, blood group and Rh factor, blood for HIV, hepatitis and syphilis.
- For a period of more than 6 weeks, an ECG is required, because The procedure will be performed under anesthesia.
- If the patient has concomitant diseases, additional tests may be prescribed.
- If the pregnancy is terminated without indication on the woman’s initiative, a conversation with a psychologist is scheduled.
How is vacuum aspiration performed?
The procedure for performing a vacuum abortion is based on the use of an electric vacuum pump in the operation to extract the fertilized egg from the uterus. Using a pump, a uniform negative pressure is created in the uterus, as a result - the fertilized egg is peeled off from the walls of the uterus and sucked out.
The vessels of the uterus are not damaged during vacuum aspiration, and avoiding the use of metal dilators allows one to avoid trauma to the uterus, which reduces the likelihood of developing cervical insufficiency, which in the future may prevent childbearing.
Preparation period
Before the procedure, the woman visits a gynecologist. During the consultation, the doctor decides on a mini-abortion, finds out the duration of pregnancy, and prescribes a number of tests. The patient is sent for research:
- for sexually transmitted diseases;
- flora smears;
- blood analysis;
- coagulogram;
- Ultrasound.
Before performing the procedure, the gynecologist makes sure that there are no indications, including the absence of a genital tract infection.
At the first stage of the operation, the external genitalia are treated with an antiseptic. Access to the uterus is provided by gynecological speculum.
The cervix is treated with a disinfectant, and sometimes the patient is given local anesthesia, although most often it is done without it.
A catheter is inserted into the uterine cavity with slow rotational movements. Under the influence of negative pressure created by a vacuum apparatus, the contents of the uterus are exfoliated and expelled.
Benefits of the procedure
The main advantage of the procedure:
- the possibility of carrying it out on an outpatient basis;
- absence of cervical injuries;
- rapid restoration of uterine tissue and healing;
- slight deviations in hormonal levels and menstrual cycle.
After an abortion
The entire vacuum aspiration procedure takes no more than 5 minutes. After a mini-abortion, the patient should rest for several hours within the walls of the medical institution.
The gynecologist will give a prescribed course of antibiotics to prevent infections, and in case of severe cramping pain, painkillers.
If there are no complications, the woman can return to normal activities the next day.
To prevent complications after a mini-abortion, doctors recommend:
- abstain from sexual activity for a month;
- avoid heavy physical exertion and hypothermia;
- refuse saunas, steam baths and swimming pools;
- You can’t take hot baths after a mini-abortion, only warm showers;
- maintain genital hygiene;
- take antibacterial drugs to prevent infectious complications;
- take hormonal contraceptives to restore hormonal levels and exclude pregnancy.
2-3 weeks after the mini-abortion, you need to see a gynecologist and undergo an ultrasound. If necessary, the doctor will order tests.
After an abortion
Sexual activity after an abortion is not recommended for 3 weeks.
A new pregnancy should not be allowed to develop for at least 6 months.
If you want to protect yourself with oral contraceptives, the patient should take the first pill from the package on the day of the abortion.
The intrauterine device may be inserted during a gynecological examination the day after the abortion, or during your next regular menstrual period.
Bloody discharge may persist for up to 2 weeks. If you are feeling well, ultrasound monitoring is recommended 5-7 days from the start of the first post-abortion menstruation. If complaints occur (fever, pain in the lower abdomen, bleeding or purulent “leucorrhoea” from the genital tract), the patient should immediately consult a doctor.
Vacuum abortion: consequences and possible complications
Vacuum aspiration, according to doctors, is the safest operation, since there is minimal risk of injury when performing it. Nevertheless, even after vacuum aspiration complications can arise.
Doctors call possible complications during vacuum aspiration:
- perforation of the cervix or body of the uterus;
- incomplete aspiration after removal of the fertilized egg;
- inflammation of the genital organs;
- hormonal disorders;
- menstrual irregularities;
- secondary infertility.
Cleaning (scraping)
According to the method of execution, curettage resembles the procedure of abortion. In order for the specialist performing the operation to reach the uterus, it is necessary to dilate the uterine cervix. During the procedure, the inner mucous layer of the genital organ is scraped out.
Nowadays, technology and a wide range of various painkillers make this manipulation absolutely painless.
There are a number of indications for cleaning: bleeding of the uterus, confirmation or refutation of the diagnosis of an identified tumor, elimination of the remains of an incomplete termination of pregnancy or in case of complicated inflammation after an abortion, in case of spontaneous miscarriage or in the treatment of uterine polyps.
Menstruation after vacuum aspiration
On days 3-5 after the intervention, a woman may experience bleeding similar to menstrual discharge.
But this discharge is not menstruation - this discharge after surgery is associated with hormonal changes in the female body.
IMPORTANT INFORMATION
Real menstruation after a mini-abortion will appear in about a month. In this case, periods may be shorter and more abundant, which is associated with suppression of ovarian function. The menstrual cycle that follows will not differ from the regular monthly cycle.
Urgent termination of pregnancy immediately after conception
It is possible to terminate a pregnancy immediately after conception. That is, in the period from several hours to several days after sexual intercourse. To terminate a pregnancy, you need to take 2 tablets of the drug Postinor 12 hours apart. If suddenly after taking the second one there was vomiting, in this case it is allowed to take the third tablet.
The first tablet should be taken as soon as possible. The drug will be most effective within the first 24 hours after intimacy; the probability of getting rid of an unwanted pregnancy is 95%. If 24 to 48 hours have passed, then the success rate is 85%.
If 48 to 72 hours have passed since conception, then in this situation the probability of successful termination of pregnancy is 59%. The drug acts in such a way that, with the help of a group of medications, it suppresses fertilization and ovulation. It is important to know that taking postinor is allowed only once during one menstrual cycle.
