Abortion: consequences and complications of mini-abortion,medical, late termination of pregnancy

Update: October 2018

No matter how sad it is to talk about it, but in Russia it’s artificial
abortion is still a popular method
�“Contraception” and by the amount of production of these operations our
the country ranks first in the world.

Women who resort to this procedure often do not
think about the consequences of an abortion
will appear in the near or distant future. No artificial
abortion does not pass without a trace, and the risk of
possible complications after the procedure, for example, are thousands of times higher
what a chance to die in a plane crash.

Medical abortion and its consequences

Medical abortion is called artificial interruption.
gestational age up to 22 weeks.

  • In the case of abortion in the first trimester, that is,
    up to 12 weeks is an early abortion.
  • In case of a later interruption (13 – 22 weeks), the abortion will be
    be called late.

Removal of the embryo from the uterus during the first 12 weeks in
Russian Federation is performed at the request of the woman, while
abortion in late periods is carried out only on honey. testimony
(if pregnancy poses a threat to the life and health of the woman) and
social (of which only 3 of
existing 13) and the decision to hold it is taken
special commission.

There are several ways to artificially interrupt
pregnancy:

  • mini-abortion – when the embryo is removed by vacuum suction in time to
    21 days of a delay of periods (about 5 weeks);
  • medical abortion – carried out by taking
    drugs – Mifegin (mifepristone), which
    inhibits the action of progesterone and provokes the rejection of the fetal
    eggs produced up to 49 days of delayed menstruation (approximately 6 – 7
    weeks);
  • surgical abortion – curettage of the embryo from the uterus
    special tool – curette (in appearance it is a spoon with a sharp edge and
    hole in the center) after pre-artificial
    enlargement of the cervical canal (produced up to 12 weeks).

Complications of medical abortion are divided into early and
late

Early are those that appeared within 10 – 30 days after
procedures or complications arising from the abortion process:

  • perforation or “puncture” of the uterus;
  • bleeding during surgery;
  • complications of anesthesia;
  • prolonged and / or massive bleeding after the procedure;
  • pelvic inflammatory disease, sepsis;
  • cervical rupture;
  • hematometer;
  • thrombophlebitis and thrombosis;
  • неудачная попытка abortion

By the late complications of abortion, manifested in a month or more,
relate:

  • violation of the menstrual cycle;
  • chronic inflammation of the uterus and appendages;
  • adhesions in the pelvis;
  • ectopic pregnancy;
  • placental polyp;
  • Asherman syndrome or intrauterine synechia;
  • infertility (see boron uterus with infertility);
  • complicated during subsequent pregnancies and habitual
    miscarriage;
  • the occurrence of anatomical isthmic cervical
    failure, background processes of the neck;
  • endometriosis;
  • post-abortion syndrome;
  • increase the chances of occurrence of rhesus conflict with the next
    pregnancy;
  • endocrine disorders.

see the propensity for abortion is inherited.

Perforation of the uterus

Perforation or perforation of the uterus is called iatrogenic.
complication when the uterine wall is in the process of committing intrauterine devices
manipulation of the surgical instrument is “punctured” through and through.
This may be a perforation probe, expander, curette or
abortion kts (most dangerous).

No gynecologist is insured against this complication,
regardless of his experience (in the “history” of any doctor performing
abortion, at least one, but there is a perforation), since the scraping
uterine cavity is made blindly.

Perforation may be uncomplicated when the surgeon feels that
the instrument “went away” too deeply, but the internal organs of the abdomen
damaged and complicated when through a perforation hole in
cervical canal extracts intestinal loop, omentum portion,
urea or other organ.

This complication is accompanied by the appearance of sharp, very
intense lower abdominal pain during manipulation
drop in blood pressure and loss of consciousness. Perforation requires
immediate laparotomy or laparoscopy with uterus suturing or her
removal in severe cases and restoration of the integrity of the affected and
injured abdominal organs.

Bleeding during or after abortion

During gestation, the uterus begins to increase in the vessels
therefore, blood vessels grow in it, and it improves
blood supply. When the embryo is detached during surgery, the vessels
are damaged, leading to bleeding, as in
the process of scraping, and after surgery.

In case of damage of large vessels, the case may end up
uterus. Bleeding often occurs:

  • against uterine fibroids
  • improper attachment of the ovum
  • after numerous deliveries.

Also often bleeding occurs with medication.
abortion (“Elephant” doses of hormones in addition to miscarriage increase
bleeding and disrupt uterine contractility) and
требует хирургического гемостаза – выскабливания полости uterus.

If the bleeding continues for a long time (more than 10
days) or occasionally significant bleeding occurs with
clots, it is possible that parts of the ovum are preserved in the uterus
either unremoved pieces of the placenta, which ends in necessity
her re-scraping.

Cervical rupture

In the event of abortion, surgery, often
повреждается шейка uterus. So that tools can pass freely
through the cervical canal, it is artificially expanded by
the introduction of special extenders Gegar (the last number
the expander, and, therefore, its thickness corresponds to the term
pregnancy).

Tears, abrasions, and ruptures of the cervix are more likely to have consequences
first abortion, because the cervical canal has not yet passed through the process
disclosure in the process of delivery. Sometimes such breaks are so much
significant that require suturing of the cervix.

Anesthesia complication

No matter what kind of anesthesia, local or general,
the procedure is performed, there is always a risk of complications,
special after general (intravenous) anesthesia. maybe
the occurrence of allergic reactions up to anaphylactic
shock on the introduction of anesthetics, malfunction of the cardiovascular
(cardiac arrhythmia), respiratory systems (respiratory arrest
and heart, aspiration of lungs with gastric contents), further
liver problems.

Hematometer

Hematometra is called congestion and accumulation of blood in the uterine
cavity due to its difficult outflow through the cervical
channel. Medical abortion, which is far from being considered
safe, often has consequences in the form of the development of hematometers.
This complication is characterized by:

  • sudden cessation of bleeding or sharp
    decreasing them
  • pulling or aching abdominal pain, lower back pain
  • temperature increase, sometimes significant, then the appearance
    pains in the form of contractions.

Hematometer возникает в результате спазма шейки матки, что
interferes with blood outflow and due to contractile dysfunction
activity of the uterus, and stagnation of blood in its cavity leads to infection
and the development of inflammation, and in severe cases leads to sepsis.

Therapeutic measures is to appoint reducing and
antispasmodic drugs. In the absence of effect is carried out
instrumental dilatation of the cervical canal with vacuum aspiration
либо выскабливание содержимого из uterus.

Failed abortion attempt

When producing a mini-abortion, a frequent consequence is
progressive pregnancy that in medical language is called
неудачной попыткой abortion This complication often occurs when
too early termination of pregnancy, that is, if the delay
menstruation is less than 14 days.

The egg is still very small and is likely to
removal during aspiration is very low. Spotting with
this does not last long, and all the early signs of pregnancy
(breast engorgement, toxicosis, etc.) are preserved.
Repeated abortion is performed only by surgery.
способом – выскабливание полости uterus.

Pelvic inflammatory disease

The most frequent complications after abortion is the development of
pelvic inflammatory disease (in 20% of cases all
искусственных прерываний pregnancy). Due to destruction
mucus plug of the cervical canal during manipulation
Vaginal microorganisms (both pathogens and
conditionally pathogenic) freely penetrate the uterine cavity,
resulting in the development of:

  • endometritis
  • метроendometritis
  • inflammation of the appendages and circulatory tissue
  • in extremely severe cases, inflammation of the peritoneum, rectum,
    urea

The process is accompanied by:

  • temperature increase
  • the occurrence of lower abdominal pain (their nature is different, it is
    there may be nagging or aching pains or very sharp and
    intense)
  • signs of intoxication (weakness, fatigue, lack of
    appetite, nausea and vomiting)
  • pus-like secretions with an unpleasant odor.

In the absence of timely treatment, sepsis develops, which
may cause the death of the patient. Assigned massive
antibiotic therapy, intravenous infusion solutions, cold on the stomach.
In the case of peritonitis on the background of uterus pyometra, parametritis
or pyosalpinx resorted to surgical removal of the uterus and / or
appendages.

Thrombophlebitis and thrombosis

If a woman has a pathology of the blood coagulation system, then
artificial interruption of pregnancy, especially in terms of 10 – 12
weeks, contributes to the formation of excessive blood clots in the uterine
vessels that can break away from the vascular wall, penetrate
into the general circulation and disrupt the blood supply to any organ and
place

Most often, a blood clot gets into the lower limbs, which causes
vein obstruction and inflammation (thrombosis and thrombophlebitis). But in the case of
getting a blood clot in the pulmonary artery system occurs extremely
dangerous condition – pulmonary thromboembolism artery mortality
which is extremely high.

With the development of thrombosis and / or thrombophlebitis is assigned
bed rest, thrombolytic (streptokinase, etc.) and
antithrombotic (heparin, trental, chimes) therapy.

Placental Polyp

A placental polyp is a small area of ​​the placental.
tissue that lingers in the uterus or after interruption
pregnancy, or after childbirth, but retained food (that is, his
blood vessels communicate with the uterus wall) and underwent
fibrosing On the placental polyp, everything settles over time.
more and more blood clots. Manifested polyp ^

  • long smear
  • periodically alternating uterine bleeding
  • if this formation exists for a long time,
    weakness, lethargy, pallor of the skin,
    dizziness and other signs of anemia.

The treatment of this abortion effect is to conduct
hysteroscopy and followed by scraping the uterus.

Violation of the menstrual cycle

Abortion is a forced abortion during
which is a significant hormonal alteration of the body.
Therefore, artificial termination of pregnancy is nothing for him
other than biological trauma. Sudden removal of the ovum
leads to the termination of the production of pregnancy hormones, ovaries,
the pituitary and adrenal glands do not have time to reorganize to a new rhythm
work. The result is that:

  • failures in the resumption of the normal menstrual cycle
  • ovarian dysfunction
  • in some cases hormonal gynecological
    diseases: uterine myoma, adenomyosis, hyperplastic processes
    endometrium, polycystic ovary and others.
  • in addition, when scraping the endometrium during the abortion
    its deep layers (basal) may be affected, as a result
    what the new menstrual cycle uterine mucosa is growing
    uneven. Therefore, menstruation can be either scanty or
    copious (see scanty periods, causes of copious periods).
  • due to the injury of the basal layer the increase of the functional layer
    (one that is rejected in the process of menstruation) may linger,
    that is, the menstrual cycle is lengthened.

In connection with the above, the first abortion is especially dangerous. About,
what is possible and what is impossible after an abortion, see rehabilitation after
abortion

Asherman syndrome

Asherman syndrome – это частичное или полное заращение маточной
cavity as a result of the formation of intrauterine synechia in it
(adhesions). Intrauterine synechia occur due to damage
basal layer of the uterine lining and the development of inflammatory
process.

Asherman syndrome manifests itself by scanty menstruation or their
absence for 6 months or more, pain and
infertility, and with the onset of pregnancy miscarriage. Treatment
consists in a hysteroscopic dissection of adhesions followed by
the appointment of hormones (estrogen and gestagen), respectively phases
menstrual cycle to restore cyclic transformation
endometrium.

Endocrine disorders

Artificial abortion is also reflected at work.
endocrine glands that can appear only after a few years
после abortion It is known that in the regulation of the work of the menstrual cycle
not only the hypothalamus, pituitary and ovaries are involved, but also
adrenal glands, thyroid gland and cerebral cortex.

  • Clinic disorders of the central nervous system
    manifested as cerebroasthenia (irritability, fast
    fatigue, emotional lability and drowsiness).
  • Disorders in the functioning of the endocrine glands are reflected and
    on sex life (reduction or loss of sexual desire,
    anorgasmia).
  • Also trigger the development of thyroid disease.
    glands, mammary glands (up to the development of breast cancer),
    adrenal glands (read about adrenal insufficiency) and
    others

Chronic endometritis, adnexitis

As already mentioned, inflammatory diseases of the organs
childbirth system after abortion
occur in every fifth patient. Untreated or not completely
treated acute inflammatory diseases lead to chronicity
process.

In addition, many sexually transmitted infections
flow in erased form or asymptomatic, therefore inflammatory
complications after abortion are sometimes not diagnosed
(chlamydia, ureaplasmosis).

  • The danger of such infections lies not only in their
    asymptomatic or latent, but also in rapid development
    chronic endometritis, adnexitis and adhesive small disease
    pelvis.
  • Obstruction of the fallopian tubes with adnexitis, inferiority
    endometrial inflammation of the uterus, pelvic adhesions are
    causes of infertility, moreover, the more abortions are available in history,
    the higher the percentage of inability to get pregnant.
  • The same factors increase the risk of ectopic pregnancy
    the occurrence of which provoke adhesions of the small pelvis and
    obstruction of the pipe.

Pathology of the cervix

In the production of abortion forcibly expand the cervical canal,
which performs the locking function and warns
penetration of infectious agents into the uterine cavity like before
pregnancy, and in the period of its carrying, and also keeps
the fetus is inside the uterus. The longer the period of gestation, which is
abortion, the larger diameter expands the cervical canal.

As a result, cervical muscles lose their tone and elasticity,
the channel remains ajar throughout pregnancy, and with
in time, the neck becomes thinner and shortened (i.e. the
its failure and isthmus), which is called
cervical insufficiency. This condition is significantly
increases the risk of miscarriage and prenatal
fetal infection.

Also due to the artificial expansion of the cervical canal
mucosa is easily injured and infected, which predisposes to
the development of background diseases of the cervix (cervical erosion,
ectropion, cervical dysplasia).

Complicated Pregnancy

Every next abortion increases the chances of complications.
gestation in case of a woman’s desire to endure pregnancy and give birth
baby If there was a history of abortion 1, then the threat of interruption
pregnancy is observed in 26%, after 2 abortions the risk increases
up to 32%, and with a larger number in half the cases there is a threat
or her spontaneous interruption.

In addition, it is highly undesirable to go through such
the manipulation of women who have Rh-negative blood (see
rhesus-conflict during pregnancy). With each new pregnancy,
counting the one that was artificially interrupted, the immune system
female begins producing antibodies against fetal red blood cells
more and more, leading to miscarriage or
preterm labor, the development of hemolytic disease of the fetus and
newborn in the case of gestation pregnancy.

For the prevention of the development of rhesus conflict is necessary before
human abortion immunoglobulin administered to the woman by abortion
D.

Post-abortion syndrome

More than half of women who volunteered through
the procedure of artificial abortion develops
post-abortion syndrome. Its symptoms may not appear immediately, but
years after the operation. Its manifestations include:

  • depression and guilt;
  • personality changes;
  • longing and resentment towards oneself, partner, relatives, doctor, circumstances
    and so on, which forced a woman to terminate a pregnancy.

An abortion woman becomes too intolerant to
people who are aggressive cannot watch pregnant women without tears
children either do not tolerate their presence. In most cases
abortion is the reason for the breakdown of marriage / relationship between partners,
develops not only disharmony in sexual relationships, but also
distrust and aggression towards one’s partner in particular and towards men
at all.

To suppress guilt, a woman can “head over” to
work, actively engage in public affairs or resort to
relief in the form of alcohol and drugs. Permanent self-digging in
myself and the accusations are turning the former abortion patient
into an unbalanced and hysterical person, which is reflected in
physical health of the woman.

Treatment постабортного синдрома представляет непростую задачу и
consists not only in the help of a psychologist, and sometimes a psychiatrist, but also in
appeal to the church and God.

How to prevent complications and consequences?

The best abortion is an unfinished abortion, so the first place in
prevention of complications takes contraception. After the procedure
abortion patient must strictly comply
doctor’s recommendations:

  • observance of sexual rest during the month;
  • refusal to take baths, visits to saunas, baths, swimming pools and
    open reservoirs before the restoration of the menstrual cycle;
  • mandatory check-up at a gynecologist after an abortion in 7 – 14
    days;
  • undergoing prophylactic gynecological examinations every 6
    months;
  • the solution to the issue of contraception (as a rule, they recommend starting
    taking oral combination medications immediately, per day
    abortion);
  • предохранение от беременности как минимум 6 months;
  • planning next pregnancy (full examination,
    rehabilitation of chronic infectious foci, somatic correction
    diseases, avoiding bad habits and healthy lifestyle
    life);
  • before abortion a woman must pass at least
    necessary analyzes (KLA – complete blood count, OAM – common test
    urine, smear on the microflora of the vagina) and
    unsatisfactory smear results;
  • limit heavy physical labor for 3 weeks after
    abortion;
  • if any warning symptoms appear, refer to
    to the doctor as soon as possible.

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