When can you get pregnant after medical termination of pregnancy? When can you get pregnant after medical termination of pregnancy? Headaches and dizziness

Pregnancy is not always planned and desired. In some cases, bearing a child is not part of a woman’s plans, and she decides to terminate the pregnancy. Medical abortion is recognized as one of the safest and most effective methods of terminating pregnancy in the early stages. How does abortion affect a woman’s health and is it possible to get pregnant after an artificial abortion?

General information

Medical abortion is the termination of pregnancy using medications. This method is recognized as the safest for women's health. After medical termination of pregnancy, the body recovers as quickly as possible. That is why medical abortion is especially popular as the most gentle method of solving the problem of unwanted pregnancy.

Unlike surgical abortion, medical abortion does not require dilation of the cervical canal and intervention in the uterine cavity. The use of medications leads to the fact that the fertilized egg exfoliates from the walls of the uterus and comes out due to contraction of the myometrium. After a complete abortion, no elements of the fertilized egg remain in the uterine cavity, and the endometrium is slowly restored, growing layer by layer for a new cycle.

Medical abortion does not always go well. After the manipulation, complications may develop that interfere with the onset of a new pregnancy:

menstrual irregularities;
retention of parts of the fertilized egg;
uterine bleeding;
drug intolerance.

Medical abortion is performed for up to 6 obstetric weeks (42 days from the date of the last menstruation). At a later date, only surgical termination of pregnancy is possible. After an abortion, the condition of the uterus must be assessed using ultrasound. In some cases, even with a correctly performed procedure, elements of the fertilized egg remain in the uterine cavity. In this case, the woman undergoes a surgical abortion to remove all retained parts of the embryo.

When does pregnancy occur after a medical abortion?

After an uncomplicated medical termination of pregnancy, a woman’s reproductive function practically does not suffer. The endometrium grows in the next cycle, and ovulation can occur as early as 2 weeks after an abortion. If the moment the egg is released from the ovary coincides with unprotected sexual intercourse, the woman can become pregnant again. Such a pregnancy has every chance of surviving, and after 9 months the woman will be able to give birth to a child. In contrast, a pregnancy that occurs one month after a conventional surgical abortion is most often terminated in the early stages.

Most women who have a medical abortion are able to conceive a child within the next three months. This is the time it takes for the endometrium to recover. During this period, the menstrual cycle stabilizes and hormonal levels return to normal. Many women forced to undergo a medical abortion for medical reasons decide to have a new pregnancy 3-6 months after the procedure.

It happens that after a recent abortion a woman's menstrual cycle does not return to normal for a long time. Menstruation comes at different times, becomes scanty or, conversely, unusually heavy and painful. Hormonal imbalance is a common complication of medical abortion. In this case, a new pregnancy may not occur for 6-12 months or even longer.

Not all women decide to become a mother immediately after a medical abortion. It may take years before another pregnancy occurs. It is quite difficult to assess the impact of medical abortion in this case. If, despite all efforts, a new pregnancy does not occur, you should be examined by a gynecologist.

Planning a pregnancy after a medical abortion

Experts advise thinking about a new pregnancy no earlier than 3 months after a medical abortion. During this time, the woman’s body has time to prepare for bearing a child. It is important that within the specified time the menstrual cycle is restored and does not cause disruptions.

In the first three months after termination of pregnancy, it is necessary to use reliable contraception. Many women choose combined oral contraceptives (COCs). These drugs block the ovulation process and prevent the egg from maturing and leaving the ovary. Correct use of COCs not only eliminates unwanted pregnancy, but also stabilizes hormonal levels after an abortion. With drug withdrawal, many women manage to conceive a child in the first cycle.

Ultrasound of the pelvic organs;
examination for urogenital infections;
hormonal profile;
consultations with narrow specialists.

Before planning a new pregnancy, you should be examined by a gynecologist. This is especially true for women who had an abortion many years ago. An ultrasound of the pelvic organs is mandatory. If any problems are identified, you need to treat them in advance, otherwise it will be quite difficult to carry and give birth to a healthy child at term.

After medical termination of pregnancy, the risk of intrauterine infection is minimal, but it cannot be completely eliminated. The likelihood of infection increases if, after an abortion, a woman does not maintain the required 21 days of sexual abstinence. Slow inflammation in the uterus can cause infertility in the future. Intrauterine infection increases the risk of ectopic and regressive pregnancy, as well as early miscarriages.

In the first 3 months after an abortion, a woman should take care of her health. With the onset of a new pregnancy, the body must be fully prepared to bear a child. How to help your body cope with double load?

Taking folic acid to prevent fetal malformations.
Taking multivitamins (in winter and spring).
Balanced diet.
Adequate physical activity (fitness, walking, cycling, swimming in the pool).
Rejection of bad habits.
Creating a favorable and friendly atmosphere around you.

Early abortion is done not only at the request of the woman, but also for medical reasons. The reason for terminating a pregnancy may be anembryonia, embryo death, or serious illness of the mother. In this case, before planning a conception, you should undergo examination and treatment by a specialist. Until complete recovery, do not forget about reliable contraception.

The course of pregnancy after medical abortion

In most cases, pregnancy after a medical abortion proceeds quite well. If the procedure went without complications and the hormonal levels have been restored, there are no prerequisites for problems to arise during a new pregnancy. Despite this, women who have had an abortion should be under medical supervision until delivery. The scope of examinations does not differ from the standard scheme.

Problems with a new pregnancy may arise if the medical abortion was completed with complications. Menstrual irregularities, hormonal imbalance - all this can lead to various health problems. Women who have had a complicated abortion in the past are more likely to have a miscarriage in early pregnancy. Premature birth before 36 weeks cannot be ruled out.

The situation gets worse if, during a medical abortion, not all parts of the fertilized egg come out of the uterus. In this case, vacuum aspiration of the embryo and its membranes is carried out with further curettage of the uterine cavity. The procedure is quite traumatic, and not all women manage to recover quickly from it. A common complication of surgical abortion is chronic endometritis, which can cause infertility. Complicated abortion also increases the risk of repeated miscarriages in the early stages.

A medical abortion that provokes infection of the uterus can cause placental insufficiency and natural fetal hypoxia. The development of polyhydramnios and infection of the child is possible. The course of labor will depend on the general condition of the woman and child throughout pregnancy.

Medical abortion is not a death sentence for a woman. Even if complications develop after the procedure, the birth of a healthy child in the future is possible. With proper rehabilitation, conceiving and bearing a baby can occur without any problems. Precise recommendations on preparing for a new pregnancy can be obtained from a gynecologist during a personal visit.

Artificial termination of pregnancy in the early stages is carried out in three ways - using vacuum aspiration, surgical intervention (curettage) and medication. The last option is considered the most harmless to a woman’s body.

It involves taking drugs that destroy the network of blood vessels connecting the fertilized egg to the uterus. As a result, it peels off and a miscarriage occurs. There is often an opinion among women that medical abortion is completely harmless.

This misconception provokes many to use it as contraception after unprotected sexual intercourse. But in fact, this is not just a miscarriage - it is a severe blow to the body’s endocrine system.

How is a medical abortion performed?

The drugs used for medical abortion contain synthetic steroidal antigestagens. To maintain the vital activity of the fertilized egg, a normal concentration of progesterone in the blood of the expectant mother is necessary. If it is not enough, the functioning of the vascular network connecting the embryo and the mother’s body deteriorates.

Drugs for medical termination of pregnancy block the flow of progesterone, which provokes the gradual peeling of the membranes of the fertilized egg from the wall of the uterus where it was implanted.

In addition, each of these drugs increases the tone of the uterus and provokes contractions in order to expel the embryo from its cavity. Then the miscarriage occurs naturally.

Consequences for women's reproductive health

Despite the absence of mechanical damage to the uterine mucosa, this method of getting rid of an unwanted pregnancy can have a number of consequences:

Hormonal imbalance– a very common side effect of taking abortifacient drugs. The endocrine system, which has adapted to nurturing the fertilized egg and maintaining conditions for the vital activity of the embryo, suddenly receives a sharp command to stop producing some hormones and start producing others.

With a natural miscarriage, the decrease in hormone concentration occurs smoothly and the woman’s endocrine system has time to restructure.

Incomplete abortion– occurs when the dose of the drug is not high enough - parts of the fertilized egg may remain in the uterus. If a woman does not attend an ultrasound examination within the first two days after a miscarriage, an inflammatory process will begin, which can provoke the appearance.

In this case, the onset of pregnancy after medical termination of pregnancy will be fraught with considerable difficulties.

Intrauterine synechiae– suggest the formation of tissue adhesions in the uterine cavity. Fusion can be either partial or complete. The occurrence of synechiae can be provoked by the remains of a fertilized egg that did not completely emerge from the uterus during a medical abortion.

In order to conceive a child, you will have to cut the adhesions. But even after this, pregnancy in such a patient will be at risk.

Placental polyp- is a neoplasm in the uterine cavity, which is a particle of the fertilized egg. The difficulty of treating this consequence of medical abortion is that initially these particles are so small that the doctor cannot notice them on an ultrasound.

Over time, clots from menstrual bleeding settle on them - this is how a polyp is formed. Future pregnancy will be at risk if measures are not taken to treat this pathology.

You can plan to conceive only 5-6 months after termination of pregnancy with the help of medications. Theoretically, it could happen earlier, but the above period must be waited for two reasons.

Firstly, the endocrine system must return to normal, and secondly, the woman needs time to carry out the following examinations before planning a pregnancy:

Ultrasound of the uterus and appendages to exclude synechiae and polyps, which may result from an artificially induced miscarriage.
Hormonal examination. It is necessary to make sure that the endocrine system produces the necessary concentration of hormones, without which the maturation of the egg and subsequent pregnancy are impossible.
Study of the patency of the fallopian tubes. It is prescribed if, after a medical abortion, an extensive inflammatory process has developed in the uterine cavity.
A gynecological examination is a standard procedure during planning. The doctor will objectively assess the consequences of artificial termination of pregnancy and how to deal with them. It is the gynecologist (or gynecologist-endocrinologist) who should prescribe treatment in cases of hormonal imbalance.

In most cases, after taking antigestagenic drugs to terminate an unwanted pregnancy, a woman retains her reproductive functions and there are no obstacles to having children.

Despite the hormonal imbalance that occurs after taking the drugs, a woman can become pregnant after a medical termination of pregnancy within a month.

In this case, a very difficult situation is created: to interrupt again means to cause serious harm to the body. Leaving a child means putting the fetus at serious risk, which will find it difficult to stay in the uterus for the entire term in a uterus that has recently suffered a miscarriage.

Complications of repeated abortion:

Serious, the consequences of which can remain forever (often - hirsutism, excess weight).
Impaired ovarian function, which may manifest itself in a decrease in the production of gestagens.
Severe intoxication of the body.
Severe bleeding, which will be a consequence of the fact that the endometrium has not had time to recover after a recent miscarriage.

Complications when leaving pregnancy:

Isthmic-cervical insufficiency, manifested in the early stages. This risk arises because in the first weeks after a miscarriage, the cervix is still completely closed.
Rejection of the fertilized egg due to insufficient concentration of progesterone in the blood, which will be a consequence of hormonal imbalance.
Increased risk of frozen pregnancy. It occurs due to improper functioning of the endocrine system. After taking a high dosage of antigestagenic drugs, the hypothalamus and pituitary gland restore their functions within several months.

Since early pregnancy after a medical abortion is associated with great difficulties, you need to pay increased attention to contraception for six months.

If necessary, you can combine several types of protection against unwanted pregnancy - for example, using a condom, the calendar method, and keeping a basal temperature chart.

Menstruation after medical termination of pregnancy may be irregular for 3-4 months. If the cycle cannot improve within six months, you should consult a doctor. You may need hormone therapy before planning to conceive a child.

If spotting does not stop for more than 14 days after interruption, this is a reason to consult a doctor. Perhaps the contractions of the uterus were not intense enough and clots remained in its cavity, which can lead to inflammation. If it affects the fallopian tubes, then pregnancy planning may be delayed for a long time.

After a medical abortion, it is advisable to take a blood test every month for testosterone, estradiol and progesterone. Monitoring is necessary in order to promptly correct emerging deviations of a particular hormone from the norm.

Abortion drugs are designed to ensure that within six months a woman will be ready to conceive a child. But before this, it is necessary to undergo all recommended examinations in order to eliminate possible risks when carrying a baby.

The consequences of medical termination of pregnancy are less dangerous than surgical ones, but in the absence of qualified assistance they can lead to infertility and even death. Taking pills is not difficult, however, despite the apparent simplicity of the procedure, it causes serious changes in the body: a large dose of hormones affects the reproductive system and disrupts the natural processes of preparation for bearing a fetus.

Vomit

This complication develops in approximately 44% of women when taking misoprostol orally, and in 31% when taking intravaginal misoprostol. Studies also confirm that the frequency of vomiting is influenced by the interval between taking a hormonal drug (Mifepristone) and a prostaglandin (Misoprostol). The likelihood of this symptom is lower if the interval is 7-8 hours than with a daily break.

Nausea

This symptom is more common than other gastrointestinal disorders during medical abortion. It has not been fully established what exactly it is caused by: exposure to drugs or termination of pregnancy.

However, a trend has been identified in which nausea is more pronounced with a high dose of Misoprostol (a prostaglandin), rapid administration and a gestational age of 6-7 weeks. If vomiting occurs, you must inform your doctor. You may need to take the pills again.

Allergy

Allergic reactions as a consequence of medical abortion can develop to the components of any of the drugs taken. Most often it is a rash or hives. Severe manifestations, such as Quincke's edema and breathing problems, occur extremely rarely. To avoid this complication, after taking medications you should stay in a medical facility (clinic) for at least a few hours.

Diarrhea

Stool disorders develop in approximately 36% of women when taking Misoprostol orally and in 18% when taking Misoprostol intravaginally. The symptom can have varying degrees of severity. The effectiveness of taking antidiarrheals in such cases has not been proven. Diarrhea usually stops on its own after a few hours.

Severe abdominal pain

This symptom is caused by spasm of the muscles of the uterus, which is part of the mechanism of action of the hormonal drug. It is observed in 96% of women and is considered normal. The severity of pain can vary: from mild to unbearable. The symptom begins to increase rapidly 30-50 minutes after taking Misoprostol and most often goes away after the abortion is completed. There is a tendency that the shorter the pregnancy, the easier the pain.

To eliminate it, non-steroidal anti-inflammatory drugs (Ibuprofen, Naproxen) are used, and in severe cases, narcotic painkillers (Codeine, Oxycodone).

Convulsions

Appear approximately 1.5-3 hours after taking Misoprostol. Most often localized in the groin area. They subside after the abortion is completed. A warm heating pad can be used to reduce pain.

All of the above complications do not require special treatment and most often go away on their own after the abortion is completed. When they are severe, symptomatic remedies are used.

Medium-term consequences and complications

Medium-term effects occur within a few weeks of medical abortion.

Bleeding

This symptom appears early, some time after taking the pills. If the bleeding volume corresponds to menstrual bleeding (no more than 1-2 pads per hour), lasts 7-14 days and gradually decreases, then there is no cause for concern - this is not a complication, but a normal process.

In some cases, women notice discharge for up to 30 days, but it is spotting and is not accompanied by pain or other symptoms. If the bleeding is heavy (2-3 or more pads per hour), prolonged and/or accompanied by pain, then you must immediately inform your doctor. This complication is rare and develops against the background of incomplete abortion or infection.

The longer the pregnancy, the higher the risk of abnormal bleeding. In 0.4% of cases, blood transfusion is performed, in 2.6% - suction curettage. Without timely medical assistance, death cannot be ruled out.

Continuing pregnancy or incomplete termination

In 1-4% of cases, the fertilized egg is not expelled from the uterus or is not completely expelled. This can happen for several reasons: the dose of the drug is incorrectly calculated, the timing of the procedure is too late, there are hormonal disorders or inflammatory processes in the woman’s body.

Such consequences after medical termination of pregnancy are accompanied by prolonged and undiminished bleeding, nagging or cramping pain in the lower abdomen, increased temperature, and fever. You cannot cope with them on your own; hemostatic drugs will not help.

An ultrasound and follow-up are required. If this is not done, then in the event of an incomplete abortion, the remnants of the fetal egg will lead to the spread of infection, general blood poisoning and death. If the pregnancy continues to develop, then the risk of having a child with serious malformations is high.

Pain in the lower abdomen

Normally, cramps in the uterus gradually disappear after the abortion is completed. If the pain continues, this may be a sign of infection or incomplete termination of pregnancy. This symptom requires examination by a gynecologist and ultrasound.

Headaches and dizziness

These consequences of medical abortion develop in 20% of women. As a rule, the cause is a large loss of blood. Weakness, decreased blood pressure, and presyncope are also observed.

If dizziness is accompanied by bleeding, then the help of a doctor is necessary. In another case, you can take an analgesic, rest more often, and change your body position gradually.

Long-term effects and complications

Long-term consequences of medical abortion are rare but most difficult to treat. They appear after several months and even years.

Menstrual irregularities

If menstruation began on time (counting from the date of abortion) or was delayed by 7-10 days, this is a sign that the reproductive and endocrine systems have recovered. About 10-15% of women note that in the first few cycles, menstruation is more painful and heavy, but soon becomes the same as before.

A complication will be indicated by a delay of more than 40 days or heavy periods, accompanied by cramping intense pain, fever, and deterioration in general well-being.

In the first case, either a re-occurrence of pregnancy is possible (this happens already 2 weeks after an abortion), or a disruption in the functioning of the ovaries. It is necessary to consult a doctor, he will determine the cause and prescribe the necessary procedures. Oral contraceptives are often used to restore hormonal levels.

If your periods are very heavy, with severe pain and a rise in temperature, then perhaps particles of the fertilized egg remain in the uterus and/or an infection has developed.

After a doctor’s examination and ultrasound, curettage is performed and antibiotics are prescribed.

Infectious and inflammatory diseases

They develop after a medical abortion as an exacerbation of chronic forms or due to remaining particles of the fertilized egg. If a woman had hidden, sluggish infectious and inflammatory processes (salpingitis, gonorrhea, etc.) before the abortion, then after the abortion procedure they may begin to progress.

This is manifested by pain in the lower abdomen, discharge with an unpleasant odor and a greenish color, purulent impurities, and increased temperature. After laboratory diagnosis, the doctor prescribes antibiotics, most often in a hospital setting.

Infertility

The causes of this serious consequence are hormonal disorders or inflammatory diseases of the uterus and appendages.

In the first case, the balance of male and female sex hormones is disrupted, as a result of which the process of fertilization of the egg and its attachment to the wall of the uterus is hampered.

Inflammatory processes can lead to the formation of adhesions and narrowing of the lumen of the fallopian tubes. This prevents the egg from moving to the uterus.

Changes in emotional state, character

Sometimes hormonal imbalance and the abortion procedure itself affect the characteristics of a woman’s psyche. She may become overly irritable, aggressive or whiny, depressed, lethargic.

At first, such reactions are observed only in difficult situations, for example, during or after a quarrel. But soon they become total, arising without external causes.

To eliminate the problem, you need to see a doctor: a psychiatrist or psychotherapist, or consult a psychologist.

Medical abortion and its consequences are still being studied. Research confirms that the earlier the abortion procedure is performed, the lower the risk of complications.

The most common among them are bleeding, pain in the lower abdomen, and infection. The consequences are associated with hormonal disorders and the risk of incomplete release of the fertilized egg. Disruptions in the menstrual cycle, development of inflammation, and infertility may occur.

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Abortion is a big stress for the body, but how long after a subsequent pregnancy is possible? Reconception is theoretically possible within two weeks. However, the body will not be ready for a new pregnancy in such a short time. It is important to see a gynecologist during the rehabilitation period after an abortion and follow his recommendations in order to avoid complications, including secondary infertility.

Methods of termination of pregnancy

Three methods are used to artificially remove the fetus from the uterus:

It is carried out no later than the fifth week of gestation; it is also called a mini-abortion. A catheter is inserted into the uterine cavity, generating negative pressure, which provokes detachment of the embryo from the epithelium. Tissue damage during vacuum aspiration is minimal.

Medical abortion (pharmabort). Very simple procedure. In the presence of a specialist, the woman takes a special drug that causes fetal death. After a couple of days, another medicine is taken that causes contractions of the uterus to remove the dead fertilized egg. This method of termination of pregnancy is used for up to six weeks.

Instrumental abortion. The most dangerous, but the most common type of abortion, permissible if the gestational age has not exceeded sixteen weeks. General anesthesia, dilatation of the cervix, curettage of the walls - all this can cause complications, including infertility.

Probability of repeat pregnancy

There are risks of developing infertility after an abortion. But in most cases, a woman can conceive, carry and give birth to a healthy baby after aspiration.

The chance of conception depends on the occurrence of complications after an abortion, the method of aspiration, and the gestational age. The hormonal background of a pregnant woman gradually changes. And with an artificial interruption, a failure occurs. In addition, abortion can cause psychological trauma.

Pregnancy immediately after an abortion

Some patients believe that pregnancy immediately after an abortion is impossible and do not take contraception.

It is practically possible to conceive a child again through unprotected sexual contact within two to three weeks after the procedure. For the female body, termination of pregnancy is a signal for the beginning of a new, next cycle of preparation for ovulation. In the standard course of the process, the egg is ready for fertilization after fourteen days.

But the ability to conceive again does not mean the ability to bear a child: the body needs more time to fully recover.

Pregnancy in the first cycle after an abortion most often ends in spontaneous miscarriage. This is explained by the fact that the endometrium, necessary for the implantation of the fetus, has not returned to normal, and the woman’s immunity is greatly weakened.

Rehabilitation after abortion

A woman planning a new conception should find out how long after the procedure she can become pregnant again. The exact time will be calculated by the attending physician. The duration of the recovery period after aspiration depends on:

woman's health status;
her immune system;
the presence and severity of complications after the procedure;
normalization of the menstrual cycle and the flow of menstruation.

Pregnancy after medical termination

You have the greatest chance of getting pregnant quickly after a medical abortion, since this method of termination causes the least harm to the woman’s body. In this case, reproductive functions are restored on average within a month.

Complications after abortion

Getting pregnant after medical termination of pregnancy is allowed after about 3-6 months, and after curettage or vacuum, recovery can last almost a year. These two methods of interruption are associated with injuries to the cervix, mucous membrane and blood supply to the genital organs.

Bearing and giving birth after undergoing a vacuum or surgical abortion, aggravated by complications, must be strictly under the supervision of a specialist, following all instructions, since such an abortion can:

Losing a baby due to cervical dilatation at the end of the second trimester. If the cervical canal is injured during an abortion, the cervix may not be able to withstand and open, causing a spontaneous miscarriage.
Find yourself on the operating table for a caesarean section. Due to damage to the endometrium during an abortion, after a new conception, the fertilized egg will find a less damaged area to attach to in the lower part of the uterus. If the fetus is located in this way, a low location or placenta previa is diagnosed, which will make natural childbirth impossible, provoke fetal hypoxia, and delays in the development of the child.
Provoke uterine rupture. Abortions performed many times thin the walls of the uterus, and perforation of this organ is possible during curettage or aspiration. During a new pregnancy, the uterus may not be able to withstand it and rupture due to stretching, which can lead to the death of the child and mother.

You can minimize the negative consequences of abortion by following these rules:

If abortion is unavoidable, it should be done at the earliest stages of gestation with the help of medications to avoid complications and long recovery.
Follow the recommendations of your doctor.
If you experience any discomfort, consult a doctor for examination and treatment.
Use contraceptives immediately after interruption.
When planning to have a child, undergo an examination and take into account all the recommendations of the gynecologist after pregnancy.

Preserving a woman’s reproductive health involves gentle performance of all gynecological manipulations. This also applies to termination of pregnancy. It is known that the earlier the procedure is performed, the less dangerous the complications. It is optimal to completely abandon this manipulation, but this is not always possible. Therefore, it is recommended to perform an abortion with the help of medications for a short gestation period.

What is a medication method?

Replacing the surgical instrument and vacuum aspirator with hormonal drugs made it possible to develop a method of pharmacological abortion. This is a non-invasive procedure for getting rid of pregnancy in the early stages, which occurs spontaneously.

Its advantages are associated with the following factors:

efficiency 98-99%;
no possibility of injury to the uterus or cervix during surgical procedures;
low risk of ascending infection;
there is no danger of getting HIV, hepatitis;
there are no risks caused by anesthesia;
can be used in primigravidas, the effect on women's health is minimal;
low level of stress, does not create a traumatic situation.

The procedure does not require a long hospital stay. After the patient has taken medications that cause a medical abortion, bleeding can be expected at home. But self-administration of medications without a doctor is impossible.

Which is better, vacuum abortion or medical abortion?

This is decided individually. But the complications and degree of interference in the body with vacuum aspiration are much higher.

How is the time for an abortion determined?

The timing for medical abortion is determined by the protocol of the Ministry of Health of the Russian Federation dated October 14, 21015. They record that it is possible to carry out a gestational disorder up to 63 days, or the 9th week. But in world practice there are differences in how long this manipulation can be done. In developed countries, the period is defined as 49 days, or 7 weeks of pregnancy.

Why is such a period determined for pharmacological interruption?

At the 5th week of pregnancy, the embryo begins to acquire human features, the rudiments of many organs and the umbilical cord appear. At week 6, the placenta begins to form, and internal organs continue to develop. At week 8, the embryo already has a completely human appearance and enters the fetal stage. After this period, the formation of blood vessels in the placenta occurs, so a medical abortion can cause heavy bleeding.

The following drugs for medical abortion are registered and used in Russia:

Mifepristone 200 mg.
Misoprostol 200 mcg.

Pharmacological abortion can be used if the gestational age corresponds to that allowed by the protocol. The main condition for the successful completion of the procedure is the day of pregnancy and the presence of an embryo inside the uterus according to ultrasound results. After a caesarean section, the medical method is preferable to.

Preparation for the procedure

When you first visit a gynecologist, you need to conduct a general examination, a bimanual examination on a chair and in mirrors, and vaginal smears are taken. Blood pressure, pulse, and respiratory rate are also measured. Next, the woman is sent for an ultrasound to determine the exact day of gestation, the condition of the uterus, and the fertilized egg.

Referrals are given for blood, urine, glucose, and ECG tests. A coagulogram is prescribed if there is a history of problems with the blood coagulation system. Additional examination methods may be needed, the need for which is determined by the doctor.

Execution method

When visiting the obstetrician-gynecologist again, the patient signs consent to perform an induced abortion using pharmacological drugs. How a medical abortion is performed is determined by the clinical protocol.

For gestational age up to 63 days, 200 mg of Mifepristone is used, which the woman drinks with a doctor. A doctor's supervision is required for 1-2 hours, after which you can go home.

If the period is 49 days, 200 mcg of Misoprostol is taken at the next visit after 24-48 hours. During pregnancy 50-63 days, 800 mcg of the drug is used. This medication should be placed under the tongue, behind the cheek, or deep in the vagina. With the last method of administration, you need to lie down for 30 minutes. The patient should be observed for 3-4 hours. During this period, most people begin to bleed. If this does not happen, to achieve the result, take Misoprostol 400 mcg tablet again.

The signs of an abortion are identical to a spontaneous miscarriage. A woman feels a cramping stomach ache and menstrual-like discharge appears.

How long does the bleeding last?

For most women, it lasts 7-9 days. Blood discharge after the procedure is rarely observed until the next menstruation. If the manipulation is carried out for a period of 3-4 weeks, then bleeding is not much different from menstruation. As the period increases, the release of blood increases; sometimes the use of hemostatic therapy may be required.

After 14 days you need to appear for a follow-up examination. This is necessary to confirm that the interruption has occurred. If an unsuccessful medical abortion occurs, aspiration from the uterus is prescribed.

Contraindications

The above medications have serious side effects. Despite the high degree of safety, there are certain contraindications to medical abortion:

gestation period exceeds 63 days;
diagnosed;
large fibroids that change the internal cavity of the uterus;
infectious diseases of the genital organs in the acute period;
anemia with hemoglobin less than 100 g/l;
porphyria is a disease associated with impaired metabolism of the constituent pigment hemoglobin;
bleeding disorders, as well as taking anticoagulants;
individual intolerance to one of the drugs;
adrenal insufficiency or long-term use of glucocorticoids;
liver and kidney diseases, which are accompanied by acute or chronic failure;
severe diseases of other organs;
extreme exhaustion;
smoking when a woman is over 35 years old;
arterial hypertension;
bronchial asthma;
glaucoma;
diabetes mellitus and other diseases of the endocrine system;
hormonally active tumors;
lactation period;
pregnancy during or after taking oral contraceptives.

According to WHO recommendations, interruption using Mifepristone is possible up to 22 weeks, but the severity of bleeding increases parallel to the period. In this case, for the duration of the procedure, the patient is hospitalized in a hospital, where there is a large operating room and emergency surgical care can be provided.

Fibroids threaten the development of bleeding, but if the size of the largest node is up to 4 cm and they do not change the uterine cavity, then you can resort to a pharmacological method.

Anemia is also a relative contraindication. The consequences of medical abortion can manifest themselves in a decrease in hemoglobin concentration: bleeding after taking medications exceeds menstrual bleeding in volume and duration.

Disturbances in hemostasis have implications for the volume and duration of blood loss. If shortly before the procedure the woman was treated with anticoagulants, then an increase in blood clotting time will lead to more heavy bleeding. Women over 35 who smoke are at risk of developing thrombosis and cardiovascular diseases. Therefore, to exclude complications, a consultation with a therapist is carried out.

The use of oral contraceptives for a long time before pregnancy also affects the hemostatic system. But this contraindication is relative. If the results of the coagulogram do not reveal pathological abnormalities, then this interruption method can be used.

If pregnancy occurs while an IUD is installed, it is removed before the procedure. Further tactics do not differ from the standards.

Infection of the genital organs is a pathology that requires appropriate therapy, which should not be delayed. Medical abortion does not contribute to the development of ascending infection, and treatment of acute infection can be carried out simultaneously.

Mifepristone and Misoprostol pass into breast milk. If there is a need to interrupt during breastfeeding, then you need to express milk for up to 5 days after taking Misoprostol. During this time, the child is transferred to artificial feeding.

Bronchial asthma, high blood pressure and glaucoma are diseases that respond to prostaglandins. Therefore, in these pathologies, taking Misoprostol is contraindicated.

In addition, the contraindications for each drug should be taken into account. For the most part they coincide with those given above. It can only be supplemented with careful use of Misoprostol in patients with epilepsy, cerebral atherosclerosis, and coronary heart disease.

Possible complications

Despite the small number of complications, it is possible to determine why medical abortion is dangerous. In 85% of cases, adverse reactions in the form of abdominal pain and bleeding are moderate and no special treatment is required.

In other cases, manipulation can lead to the following complications:

severe pain syndrome;
heavy bleeding;
temperature;
incomplete abortion;
progressive pregnancy.

Pain in the lower abdomen is observed during the period of expulsion of abortion products. Its intensity may vary, but the individual tolerance threshold also matters. Analgin and Drotaverine are used to reduce pain. WHO recommendations indicate Ibuprofen to reduce pain. If your breasts hurt after an abortion, this may be due to high levels, which increase as pregnancy progresses. This symptom goes away on its own.

Bleeding is considered significant if you have to change two pads in an hour, and this condition lasts for at least 2 hours. In this case, vacuum aspiration of the contents of the uterus is indicated in order to stop it. In severe cases, surgical cleaning is performed.

In 2-5% of cases, medical abortion is incomplete. Then it is also necessary to perform vacuum aspiration or curettage of the uterine cavity. Less than 1% of cases result in pregnancy progression. If a woman insists on an abortion, then invasive methods are used. Those who have changed their decision must be informed about the possible teratogenic effect of the drugs on the fetus. But there is not enough data to confirm this fact.

Taking medications may cause a slight increase in temperature, but this lasts no more than 2 hours. If the fever lasts for 4 hours or more or occurs one day after taking Misoprostol, this indicates the development of an infectious process. A woman with these symptoms should consult a doctor.

Infectious complications are not typical for pharmacological abortion. But there is a group of people who have an increased risk of infectious complications:

, established by smear;
patients with a sexually transmitted infection up to 12 months ago, but there is no laboratory confirmation of its cure;
patients diagnosed with;
women with a large number of sexual partners or low socioeconomic status.

Other complications in the form of dyspeptic symptoms may be a sign of pregnancy itself. For allergic reactions, treatment with antihistamines is necessary.

Recovery period

After taking Mifepristone and Misoprostol, there is no disruption of the menstrual cycle. But when menstruation begins and how long it lasts after a medical abortion is difficult to predict. The timing of the procedure matters; after an earlier interruption, the cycle is restored faster.

The first menstruation may begin in 30-50 days. But medical abortion does not affect the onset, so a new fertilization is possible in the first cycle. To avoid this, immediately after the procedure the doctor prescribes combined oral contraceptives. These can be such means as Yarina, Regulon, Rigevidon, Novinet, Lindnet, Jess. The selection of a medicine occurs individually.

Protects against unwanted pregnancy in 99% of cases. The positive effect is the regulation and restoration of the menstrual cycle. The minimum period for such contraception is 3 months, but you need to wait until the body fully recovers to decide when you can get pregnant. Usually this is a period of at least 6 months.

If pregnancy occurs earlier, this can lead to complications such as:

threat of interruption;
ectopic pregnancy;
anemia in a woman.

Doctors' advice on how to restore the body after a medical abortion is as follows:

start taking oral contraceptives early;
avoid overheating and hypothermia in the first month after the procedure;
do not visit the sauna, swimming pool, or swim in open water;
do not take a hot bath, take a shower instead;
take care of your health, during the cold season, avoid crowds of people so as not to get infected;
nutrition should be balanced, with sufficient protein and vitamins;
completely give up alcohol, eliminate smoking;
At first, physical activity should be limited. Those who are intensely involved in sports or fitness should stop going to the gym for a while;
will limit stressful situations and emotional overstrain.

Sexual activity after a medical abortion is possible after the end of the first menstruation. The uterus after an artificial miscarriage is an extensive wound surface with a breeding ground for microorganisms. Sexual contact always carries a risk of infection. In addition, active frictions can cause discomfort or lead to resumption of bleeding.

Physiotherapy has a positive effect on the recovery process. The choice of a specific method of exposure must be agreed with the attending physician, because This method of treatment also has contraindications.

If the menstrual cycle does not resume within 2 months, you should consult a doctor to conduct an examination and look for the causes of hormonal imbalance. You may also be concerned about discomfort in the mammary glands, which have begun to prepare for lactation. Therefore, in some cases, a consultation with a mammologist is recommended.

Despite numerous positive aspects, medical abortion is not an ideal method. Any interference in the internal environment can lead to unpleasant consequences. To avoid them, it is necessary to approach family planning issues correctly, and not solve the problem after it appears.

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