Author: Tselmer NE, obstetrician, practical experience since 2007, the first qualification category.
March, 2019.
Vacuum abortion is done in up to 12 weeks:
- to 5 weeks it is possible to conduct the so-called mini-vacuum abortion - on an outpatient basis without dilatation.
- from 6 to 12 weeks vacuum abortion performed in a hospital using anesthesia.
For abortion this method uses vacuum apparatus by means of which the fertilized egg is sucked out of the uterus. This method is less traumatic compared with surgical abortion, since it requires a minimum interference with a woman's body, and therefore less likely to damage the uterus and the emergence of bleeding.
An alternative vacuum aspiration is medical abortion.
Indications for vacuum abortion
- For up to 12 weeks, a woman can terminate a pregnancy on their own initiative.
- Also terminate a pregnancy can recommend a doctor based on medical indications.
Contraindications
Main obstacles to the holding of the vacuum abortion, the following:
- gestational age greater than 12 weeks;
- less than 6 months after the previous pregnancy was interrupted;
- the presence of foci of purulent infection, regardless of their location in orgnizme women;
- inflammatory diseases of the genital organs;
- acute infectious diseases.
the necessary tests
- To confirm intrauterine pregnancy donates blood to determine hCG - a hormone that increases a hundredfold during pregnancy.
- Then, the ultrasound (ultrasound), Which measures the position of the fertilized ovum and thus excluded ectopic pregnancy.
- Next is taken smear the degree of purity of the vagina. Upon detection of inflammation is required Vaginal - processing antiseptic preparations.
- General blood and urine analysis, blood group and Rh factor, blood for HIV, hepatitis and syphilis.
- If more than 6 weeks is required electrocardiogram, because procedure will take place under general anesthesia.
- In the presence of the patient's co-morbidities, additional tests may be ordered.
- If pregnancy is terminated without reading on the initiative of the women, appointed a conversation with a psychologist.
Conducting a vacuum abortion
Mini abortion of pregnancy less than 5 weeks
Is carried out using local anesthesia on an outpatient basis, i.e. after the procedure the patient is sent home.
Local anesthesia involves the introduction of an anesthetic drug in the cervical tissue. In addition, for 30-40 minutes before the procedure, the woman advised to take pain-killer tablets.
When carrying out a mini-abortion woman is on the gynecological chair, the cervix is exposed in the mirrors. Through the cervical canal (without its extension) introduced special soft catheter. Vacuum suction creates a negative pressure in the uterine cavity, which compels the ovum, is inserted in the uterine wall, come off the wall and leave the uterine cavity.
Enter a soft catheter, and the absence of mechanical dilatation minimizes the risk of traumatic impact on the female body. Thereby reducing the risk of infection and damage the uterine wall and the subsequent bleeding. of mini-abortion time in normal practice, no more than 10 minutes.
Vacuum abortion during a period of 6 to 12 weeks
Held in the gynecological hospital.
uterine discharge principle is the same: a vacuum suction creates a negative pressure in the uterine cavity, and sucking the contents. But at this stage of pregnancy the nozzle diameter on Vakoumé-sucking longer, and this requires an expansion of the cervix. It is carried out mechanically with metal dilators Gegara and may be accompanied by cervical microtrauma.
Full vacuum abortion procedure usually takes about 20 minutes under intravenous anesthesia.
If for some reason the patient can not do an intravenous general anesthetic, or she does not want to completely disable the consciousness at the time of the procedure can be applied to an alternative scheme anesthesia. The physician then assigns 40 minutes before intramuscular injection procedure narcotic analgesic drug and for sedation (calming, reducing anxiety and pain threshold). Immediately prior to the manipulation on a gynecological chair doctor additionally introduces anesthetic paracervical, ie in the cervical tissue.
Abortion requires the appointment of antibacterial drugs:
- For the prevention of infectious complications once daily treatment - in patients with no risk factors, infection joining screened for chlamydia (if negative).
- Course for 7-10 days - in patients diagnosed with chlamydia or other infections, as well as the presence of risk factors for joining inflammatory complications (with bakvaginozom earlier smear, demanding rehabilitation before an abortion, women with low socio-economic status).
When Rh negative blood woman during an abortion recommended dosing Rh immunoglobulin to prevent the development of immunization and Rh conflict during the next pregnancy. This should be mandatory in the event that a partner Rh positive blood.
Usually in a hospital patient observed within days after surgery. The next day, gynecological examination avoids early complications. The patient must be determined, followed by the method of contraception to avoid re unwanted conception. In the absence of contraception pregnancy can occur already in 1-2 months after surgery.
after abortion
Sex life after an abortion is not recommended for 3 weeks.
For at least 6 months should not be allowed the development of a new pregnancy.
If desired be protected using oral contraceptives, the patient should take the first pill of the package in the day of abortion.
IUD can be inserted at the gynecological examination the day after the abortion, or during the next normal menstrual period.
Spotting can be stored up to 2 weeks. When a satisfactory state of health monitoring ultrasound is recommended for 5-7 day from the beginning of the first post-abortion menses. When the complaints (fever, abdominal pain, bleeding or purulent "whites" from the genital tract) the patient should consult a doctor immediately.
complications
More about all kinds of complications after abortion can be read in a separate article.
- Incomplete abortion - a common complication of abortion by vacuum aspiration. It occurs when the fertilized egg is removed from the uterus not completely. This can serve as the development of severe inflammation and require surgical intervention. To prevent incomplete abortion necessarily performing procedures under ultrasound guidance.
- After an abortion increases the risk of hormonal disorders - endocrine infertility factor in the future.
- Accession of inflammation and infection is common after abortion because the uterus traumatized and vulnerable.
Despite the fact that the procedure is fairly low-traumatic vacuum abortion (especially mini-abortion up to 5 weeks) Yet we should not forget that this third-party intervention in a woman's body, which was not entirely safe.
