What types of anesthesia are used during abortion?

Termination of pregnancy is a heavy blow for the female body, even if a spontaneous abortion occurs, since a miscarriage at any stage of pregnancy causes a surge in hormones, which negatively affects the general condition. In addition, a woman may experience some symptoms, including endocrine disruption, spotting, cramping and pain.

If a woman undergoes a medical abortion, the procedure may be accompanied by:

• rezhu,
• pain,
• unpleasant symptoms from the female organs.

Is anesthesia used during an abortion?

Anesthesia during abortion is done to reduce the patient's pain. Although there are clinics where abortion is performed without anesthesia. But this practice is not common. Anesthesia is needed when performing surgical curettage or vacuum aspiration.

With a vacuum abortion, pain occurs due to the expansion of the cervical canal, when the internal contents of the uterus are sucked out. When surgically interrupted, they involve the insertion of dilators into the cervix and curettage of the uterine cavity. Women who have undergone surgical termination of pregnancy without anesthesia report severe pain. Therefore, in most cases, abortion is performed under anesthesia.

If a woman undergoes a medical termination, then anesthesia is not needed. For patients with a low pain threshold, the doctor may suggest taking a painkiller tablet or injecting an anesthetic.

But after any abortion, pain may persist for several days. They are associated with contraction of the uterus, the formation of a wound surface and a sharp change in hormonal levels.

How anesthesia is done

The gynecologist chooses the type of anesthesia depending on the type of abortion and the general health of the woman.

It could be:

1. General anesthesia. There is a violent inhibition of the functions of the central nervous system. Mask and intravenous are used.
2. Local anesthesia. An injection with an anesthetic is given in the cervix. Painful sensations disappear. Performed as a preparation for epidural (into the spine area) anesthesia.
3. Sedation. This is a superficial dream. An anesthetic is used in small doses. The patient breathes independently, is conscious, and is easily brought out of the inhibited state. There are oral, parenteral (bypassing the digestive tract) and inhalational sedation.

Anesthetics are used for pain relief.

This:

• Profopol;
• Midazolam;
• Thiopental;
• Lidocaine.

Immediately before the administration of medications, an allergy test is performed.

Medical abortion

Performed up to 8 weeks during uncomplicated pregnancy. An ultrasound examination is performed first.

The woman should take 2 tablets of Mifepristone. The first (for termination of pregnancy) - in the presence of a doctor, the second (for expulsion of the fetus) - at home. Medical termination of pregnancy does not require anesthesia, but may be accompanied by pain. To relieve discomfort, a woman can take Drotaverine or any painkiller.

Bleeding will appear within 3 days. It will last 4-5 days. Another ultrasound will be performed to detect the remains of the fertilized egg, which can cause serious complications.

The patient will have:

• heavy bleeding;
• weakness;
• temperature increase;
• sharp pain;
• dizziness.

In this case, curettage of the uterus is performed. This type of abortion is only 98% effective.

Vacuum

A mini-abortion is performed within 5-10 minutes, but only in the early stages (up to 5 weeks). A vacuum aspirator is inserted into the uterine cavity. The fertilized egg with its membrane is absorbed and expelled.

It is carried out completely painlessly if general anesthesia is used, but with local anesthesia, pulling pain in the lower abdomen often appears.

To exclude the development of inflammation, the patient is prescribed a weekly course of antibiotics. The final stage is ultrasound.

Operation

The procedure is performed in a hospital. The doctor talks about the progress of the intervention and possible complications.

Using various instruments, the cervical canal of the cervix is ​​first opened, the fertilized egg is destroyed and removed. The manipulation ends with curettage of the uterine lining.

Surgery is performed during medicated sleep. The patient does not feel any pain.

What anesthesia is used to perform an abortion?

For pain relief when terminating an unwanted pregnancy, one of the following anesthesia is given:

• general short-term,
• sedation,
• epidural,
• spinal,
• local in combination with analgesics.

The choice of pain relief method is directly related to the method by which the abortion is performed.

Anesthesia for vacuum abortion

For patients who decide to have an abortion in the early stages, doctors recommend choosing vacuum aspiration. A mini-abortion is performed under local anesthesia. The patient is injected with anesthetics directly into the mucous membrane near the cervix and non-steroidal anti-inflammatory drugs intramuscularly. This combination allows you to suppress pain. Some complain of discomfort felt during the procedure.

Important! In a number of clinics, when performing abortions under local anesthesia, tranquilizers are additionally prescribed. They reduce anxiety, reduce tension and help you relax.

In many medical hospitals, vacuum aspiration is performed under short-term general anesthesia. The patient is put to sleep for 5-10 minutes. This time is enough for the doctor to widen the cervical canal, insert a plastic tube into the uterus and remove the fertilized egg and uterine lining.

Anesthesia for surgical abortion

When curettage is performed, anesthesiologists give women general short-term anesthesia. The pregnant woman is put into a deep medicated sleep, during which she does not feel anything.

Surgical abortion under sedation is permitted. This is the name for anesthesia, during which the patient is immersed in a shallow sleep. In this case, sensitivity may remain, but after waking up the patient remembers practically nothing.

Existing types of abortions

Regardless of the classification, abortion is a termination of pregnancy that occurs spontaneously or artificially through surgical intervention. If it is necessary to terminate a pregnancy, many women have a question: what types of abortions exist? The type of procedure is selected based on the duration of pregnancy and the characteristics of the patient’s body. There are surgical and non-surgical types of abortion.

Surgical ones include:

• abortion by caesarean section;
• saline abortion;
• surgical;
• vacuum.

Non-surgical termination methods include:

• homeopathic interruption;
• acupuncture;
• abortion using magnetic induction;
• medical abortion.

Before carrying out the procedure, the gynecologist must conduct a small examination of the woman in order to avoid negative consequences in the future. To do this, a series of tests are prescribed to clarify the Rh factor, determine infectious or inflammatory diseases, the level of hCG (Human Chorionic Gonadotropin - a hormone produced during pregnancy) to determine the duration of pregnancy, as well as a urine test and ultrasound. Based on the results obtained, in the absence of contraindications, the doctor selects the optimal and safe type of abortion.

The main indicator of choice is the gestational age. Termination of pregnancy can be used from three weeks - from the time when the woman’s test shows a positive result, and the doctor can see the fertilized egg on an ultrasound. At this stage, the best and safest option is abortion with the help of medications, which allow the procedure to be carried out without surgical or hardware intervention. The procedure is carried out using certain drugs that cause spontaneous miscarriage. The effectiveness of this method is 98%.

Vacuum aspiration is carried out for up to 7 weeks using a special device that allows you to effectively clean the uterus. The procedure takes no more than 10 minutes and, despite the fact that this method is surgical, it is safer and more gentle compared to other types. Vacuum abortion is used in the early stages, when the fertilized egg is not yet firmly entrenched in the endometrium. Often this method is used additionally during medical interruption in order to check the uterine cavity and, if necessary, remove remnants of fetal tissue.

How is anesthesia administered during an abortion?

In obstetrics and gynecology hospitals, there must be an anesthesiologist who is responsible for administering anesthesia. The technique for performing it depends on the type of anesthesia chosen and the patient’s contraindications to the use of certain drugs.

General

The administered general anesthesia turns off consciousness. The woman remembers the moment the drug is administered, and then wakes up after the procedure is completed. Such anesthesia is performed using intravenous administration of special drugs belonging to the group of narcotic substances:

• Ketamine,
• Calypsol,
• Propofol,
• Enflural,
• Thiopental.

The anesthesiologist selects the name of the drug and dosage for each patient individually after studying the medical history. Multicomponent formulations are often prescribed.

When performing an abortion under general anesthesia, the patient is given an amount of medication that can temporarily block brain function. Sleep medications are then continued through the IV until the surgery is completed. Scraping takes up to 20 minutes. If a vacuum abortion is performed under general anesthesia, then it can be done in 10 minutes. After the operation is completed, the woman remains under anesthesia for several minutes. She usually regains consciousness already in the ward.

When using inhalation anesthesia, the process of falling into sleep is faster. The patient regains consciousness faster. But studies have shown that the use of inhalational anesthetics increases blood loss.

Important! Hospitals that provide general anesthesia must have a ventilator, as there is a risk of respiratory arrest.

A safer type of general anesthesia is sedation. But when using this method, consciousness is not blocked, so pain persists.

Local

Vacuum abortions are performed both under general and local anesthesia. Curettage using local anesthetics is not recommended; short-term general anesthesia is more suitable for this procedure.

The doctor makes an injection through the vagina into the mucous membrane that surrounds the cervix. This allows you to reduce its sensitivity and make the process of expanding the cervical canal almost painless. The woman remains conscious all the time. She can talk to the medical staff, see the movements of instruments, but feels almost no pain.

For pain relief the following may be administered:

• Lidocaine,
• Decaine,
• Bupivacaine,
• Novocaine,
• Ultracaine,
• Tricaine.

First, you need to make sure that you are not allergic to the drug that will be used for local anesthesia. The effectiveness of anesthesia can be increased if, in parallel, to block the pain syndrome, any drug from the group of non-steroidal anti-inflammatory drugs is administered intramuscularly:

• Ibuprofen,
• Ketotifen,
• Nurofen.

If a pregnant woman experiences panic, she is additionally prescribed sedatives or recommended to choose general anesthesia. Many hospitals administer Diazepam.

It is preferable to do a vacuum abortion under local anesthesia. When it is carried out, the risk of complications is minimized; after the procedure, consciousness is not confused, coordination is not impaired. Long-term medical supervision is not required, women recover quickly. But the likelihood that sensitivity will persist and pain will be felt is high. Local administration of anesthetics only dulls the pain.

Epidural

When performing abortions, epidural anesthesia is practically not used. It is used only in cases where it is necessary to terminate a pregnancy for medical or social reasons at a late stage.

The anesthesiologist injects a medicine through a catheter into the epidural space that blocks the transmission of nerve impulses. This can be done while lying on your side or sitting. As a result, the pregnant woman ceases to feel the lower part of the body, but is conscious. The most commonly used drugs are:

• Ropivacaine,
• Bupivacaine,
• Lidocaine.

Comment! If necessary, the effect of these anesthetics can be enhanced by adding opiates. But in Russia, opioid analgesics are not used for administration into the epidural space.

Spinal

Spinal anesthesia is one of the regional types of pain relief, like epidural. The injection is given in the same place as for epidural pain relief. But to carry out such anesthesia, the doctor takes a thinner needle with a “pencil” sharpening. The injection is made below the spinal cord, into the space that contains cerebrospinal fluid. Immediately after administration of the drug, a feeling of numbness in the lower body appears.

This anesthesia is recommended for women who need a late termination. It is also indicated if there is a high risk of postoperative bleeding or the development of problems associated with impaired ability of the uterus to contract.

Existing types of medical abortion

When choosing a method of abortion, the question may arise, what is the safest type of abortion? Undoubtedly, of all the available methods, medical abortion is safer and more effective, since the procedure does not require surgery.

Medical abortion is performed in a hospital, since the woman must be under the supervision of a doctor. Medical termination depends on the duration of pregnancy and the selected drug; Mifepristone is most often used.

Deadlines:

1. Medical abortion in early pregnancy. Termination of pregnancy is carried out up to 8 weeks using certain medications. Most often these are drugs made in France, which allow you to expel the fetus after the first use. After taking it, a woman experiences a hormonal surge in her body, causing a miscarriage. The medicine is selected individually, based on the characteristics of the woman’s body.
2. Medical abortion for a period of 13 weeks or more is carried out if serious pathologies are detected in the development of the fetus, a missed abortion, or the mother has diseases incompatible with bearing a child. This method is carried out in several stages: first, the cervical canal is softened for easier extraction of the fetus, then stimulating measures are carried out to contract the uterus, and only then the fetus and placenta are removed.

These types of medical abortions are performed under local or general anesthesia and are very painful. Before carrying out the medicinal procedure, the doctor examines the woman, prescribes a series of tests and ultrasound, on the basis of which the type of medicinal drug to be interrupted is selected.

If there are no contraindications, the doctor gives the drug to the patient, after which he monitors her condition for 3-4 hours; if there are no complications, the woman is sent home. After a few days, it is necessary to conduct a second examination to ensure that the fertilized egg has been completely rejected from the uterine cavity.

The types of abortions and timing depend on each other, since some methods are used only for short periods, which cannot be used at later stages due to the risk of damage to the uterus and the poor quality of the procedure.

The ideal period for carrying out a medical abortion is considered to be 4-5 weeks; the type of abortion is best determined by the attending physician, based on the examinations performed and the characteristics of the body.

In order to find out which type of abortion is safer for a woman’s body, it is first necessary to determine the gestational age. It is important to remember that the earlier the procedure is performed, the lower the risk of complications.

Almost all types of early abortions are carried out using medication interruption, but, like all other methods, the use of these drugs may have the following contraindications:

• high blood pressure;
• scar formations on the cervix;
• pregnancy that occurs while taking contraceptives;
• late stages of pregnancy;
• intolerance to the components of the drug;
• diseases of internal organs in an acute progressive form;
• if you suspect an ectopic pregnancy.

The presence of at least one of the indicators may increase the risk of complications.

All types of medical abortion are indicated for a short period of up to 7 weeks; in some cases, if it is necessary to have an abortion at a later date, the doctor prescribes a set of required drugs.

Even the safest type of abortion can cause the following side effects:

• diarrhea;
• vomit;
• nausea;
• headache.

In addition, when using any type of medical abortion, some complications may develop, for example, incomplete gestation (incomplete rejection of the fertilized egg), severe pain in the abdomen, and uterine bleeding.

How to perform an abortion under anesthesia

In gynecological departments of hospitals, curettage or vacuum aspiration of the uterine cavity is performed under local or general anesthesia. Surgical abortion is performed under anesthesia. First, the woman sits on a gynecological chair, and the anesthesiologist administers medications intravenously. After this, the gynecologist begins the procedure:

• the cervical canal expands,
• if a mini-abortion is planned, then a tube is inserted into the uterine cavity, through which the fetus and endometrium are removed using a special vacuum apparatus,
• When performing curettage, curettes are inserted through the enlarged cervical canal and the endometrium and fertilized egg are scraped off with them.

In addition to the operating gynecologist, an anesthesiologist is present in the operating room at all times. After the abortion is completed, the woman is moved to the ward, where she regains consciousness. After this, she should be visited by an anesthesiologist and a surgeon to check the condition and make sure there are no complications. If no problems arise, the woman can be sent home on the same day.

General anesthesia - algorithm of actions and drugs used

Termination of pregnancy under general anesthesia is a more complex procedure. First of all, the doctor examines the woman for the presence of allergic reactions to the drugs used and the presence of ailments. Before an abortion, the patient must undergo laboratory tests and adhere to recommendations for eating on the day of surgery, since the termination of pregnancy takes place on an empty stomach.

General anesthesia is used for late-term abortions using a minor caesarean section. At this stage, the fetus already occupies the entire uterine cavity; during the process of termination of pregnancy, the uterine walls are injured, and bleeding may occur.

General anesthesia may be administered intravenously . The list of drugs used is quite wide. Often tranquilizers with sleeping pills or narcotic medications are used. Each type of medication has its own duration of action. Therefore, when carrying out the procedure, personal usage patterns are used.

Intravenous anesthesia is used for periods later than the 2nd trimester. The painkiller acts almost instantly, putting the patient into deep sleep. A large dose of the drug is immediately used, which inhibits brain activity and nervous sensitivity. When the required condition is achieved, the drug is continued to be administered, but the dose is reduced. After the abortion, the drip with the drug is removed, and the woman is transferred to a ward where she recovers.

Inhalation anesthesia - a special mask is used that supplies the body with a cocktail of oxygen and anesthetic. The effect of anesthesia occurs a couple of minutes after the woman has put the mask on. Inhaling anesthesia vapors can dull consciousness and put the patient into deep sleep. At this time, all sensitivity is lost and muscle tissue relaxes.

Painkillers that are used today: Thiopental, Fentanyl, Ketamine, Profopol, etc.

Is it painful to have an abortion?

If the patient undergoes the termination procedure under general anesthesia, then there will be no discomfort during the procedure. After the abortion is completed and consciousness is restored, many complain of aching pain. Their intensity varies from weak to strong. Much depends on the pain threshold, psychological mood and type of interruption.

But pain is associated not only with the curettage procedure itself, but also with the expansion of the cervical canal. Therefore, even a mini-abortion is performed under anesthesia. This will help reduce discomfort during the procedure.

With local anesthesia, women feel pain, but it is dull. Therefore, this type of anesthesia is used mainly with vacuum aspiration. During this procedure, discomfort occurs when the tube is inserted through the cervix into the uterus and the aspiration itself is performed. But this lasts no more than 5 minutes. Immediately after completion of the procedure, the pain goes away and the patient’s condition returns to normal.

Comment! The appearance of pain after an abortion is associated primarily with the formation of an extensive wound surface inside the uterus and its active contractions. The condition is also affected by sudden hormonal changes that occur in the body.

When is an abortion necessary?

Termination of pregnancy is the deliberate cessation of fetal development before 12 weeks of gestation. However, abortion can be performed at a later date. In this case, the indication for the procedure is not the woman’s desire, but compelling medical reasons. These include:

• pathological disorders in the functioning of the heart muscle;
• severe impairment of kidney function;
• serious liver pathologies;
• severe illnesses of the circulatory system;
• pathologies of the respiratory system;
• severe neurological disorders;
• tumor development;
• infectious lesions;
• development of tuberculosis;
• diagnosis of hepatitis C during pregnancy;
• identifying the patient’s strong dependence on drugs or alcohol.

Mini-abortion without anesthesia

Some hospitals practice vacuum aspiration without anesthesia. If the clinic does not have resuscitation equipment, then doctors do not risk using general anesthesia. If the patient cannot be given drugs that are used for local anesthesia, then she will have an abortion without anesthesia. Reviews from women indicate that this is a very painful manipulation.

Is it possible to have an abortion without anesthesia?

There are no contraindications for performing an abortion without prior anesthesia. Some doctors argue that it is better to endure a few minutes of pain than to suffer from the effects of anesthesia. If you do not administer drugs that depress consciousness, recovery is much faster.

Women who easily tolerate pain may agree to a vacuum abortion without anesthesia. But you must be prepared that this is a very painful procedure. According to women, removing nerves from dental canals without anesthesia is much more pleasant.

Is it painful to have an abortion without anesthesia?

Termination of pregnancy without anesthesia is one of the most painful procedures. Nowadays, surgical and vacuum cleaning of the uterus without anesthesia is used in rare cases. This is possible if the patient is allergic to all known anesthetic drugs or has contraindications.

Unlike a mini-abortion, which is performed within a few minutes, curettage of the uterus without prior anesthesia is practically not practiced. Judging by the reviews of women who have undergone this procedure, they note that it is very painful to have an abortion without anesthesia. The sensations are much stronger than during childbirth and other painful medical procedures.

Choosing an abortion clinic

When choosing a clinic where you plan to have an abortion, you need to take into account a lot of subtleties, including the methods of pain relief provided. To do this, you may need to collect the coordinates of various institutions, systematically call them, record and analyze the information received, and only then make a decision.

To make this task easier for you, there is the “Your Doctor” website. On it we have already collected information from various medical institutions in Moscow, which will make it easier for you to choose the best clinic and then sign up for a preliminary consultation directly on the site.

Publication date: 2019-04-24

Useful information on the topic:

• Calling a gynecologist to your home
• Consultation with a gynecologist
• HCG tests
• Ultrasound during pregnancy
• Diagnosis of sexually transmitted diseases
• Fetal ultrasound
• Pelvic ultrasound
• Ultrasound during pregnancy
• Transvaginal ultrasound
• Discharge in women

Consequences of anesthesia during abortion

Any medication that is used to put a patient under anesthesia has contraindications and can cause complications. Possible negative consequences include:

• nausea,
• dizziness,
• vomiting
• disturbance of heat exchange (appearance of hot flashes or chills),
• fainting,
• disorientation,
• memory losses,
• breathing problems,
• blood pressure surges,
• decrease in hemoglobin,
• skin allergic reactions,
• development of problems with blood clotting.

Attention! Most often, these symptoms develop as a side effect of the drugs used. If the condition does not normalize for a long time, the doctor should select drug therapy.

Is it painful to have a medical abortion if you have increased or decreased sensitivity?

When a woman hears the word abortion, she assumes the use of a surgical or vacuum method, and since such procedures relate to surgical intervention, the appearance of unpleasant and painful sensations is not excluded. But there is a more gentle method of terminating pregnancy - medication, which allows you to perform an abortion without the use of instruments and intrusion into the uterine cavity.

But, despite the more positive characteristics of medical abortion, the appearance of pain is not excluded. Unpleasant sensations develop due to the fact that after taking the medication, the fetus is destroyed, and hormonal changes occur in the body, which leads to spasm of the uterine muscles. While waiting until a forced miscarriage occurs, a woman may experience pain in the lower abdomen, similar to menstrual pain. But if the pain is so severe that it is impossible to endure and in addition to this there are additional symptoms (dizziness, headache, nausea), you must urgently inform your gynecologist or call an ambulance.

It is worth considering that each woman’s body is individual and may react differently to the drug used. Some patients experience a pronounced contraction of the uterus with severe pain, while others experience a less weak contraction that does not cause severe discomfort.

If a woman’s menstruation is painful, this indicates increased sensitivity, therefore, if interrupted by medication, you should be prepared for pain.

Reviews about abortion under anesthesia

Victoria Marusich, 32 years old, Izhevsk The third pregnancy came as a complete surprise to my husband and me, so at a family council we decided to have an abortion. The period was already 8 weeks, so I had to agree to a regular curettage under general anesthesia, which is administered intravenously. I fell asleep in the operating room, they woke me up there and transported me to the ward. After 4 hours, the doctor sent me home, since my health was satisfactory. Anna Aksentyeva, 38 years old, Moscow Had an abortion due to a missed abortion at 11 weeks. The procedure itself took about 20 minutes from the moment the anesthesia was administered until I came to my senses. After the procedure, I felt a little dizzy and nauseous. But after 2 hours the condition returned to normal.

Period after abortion

If the termination of pregnancy was performed by an experienced doctor in a medical facility, the procedure does not cause serious complications. The woman can go home the same day, but should avoid strenuous physical activity. In the first hours, minor pain is usually felt in the lower abdomen. This is a natural reaction of the uterus, which at this time is a bleeding wound.

During the post-abortion period, slight bleeding is observed, similar to normal menstruation.

How long does the discharge last?

Normally, their duration should not exceed 5-7 days.

If the amount of discharge exceeds the norm, hemostatic drugs may be prescribed: water pepper extract, aminocaproic acid, Tranexam. It is possible to use folk remedies: decoctions of nettle, hogweed, red brush. If the discharge continues longer and, moreover, comes profusely and with clots, you should consult a doctor.

Within 2-3 days, body temperature can be raised to 37-37.5 °C. Higher rates within a week after an abortion indicate the presence of an inflammatory process and also require consultation with a doctor.

During the post-abortion period, the following rules must be observed:

1. Do not lift heavy objects, avoid physical activity and stressful situations.
2. For several days, do not take a bath, do not swim in the pool or open water.
3. Make sure to keep your lower body warm.
4. Avoid smoking and alcohol.
5. Maintain sexual rest for 3-4 weeks.
6. Monitor the quality of food.

1-2 weeks after the operation, the woman should visit the doctor and undergo an ultrasound to make sure that it was carried out with minimal consequences for the body. After the examination, the doctor will help you choose contraceptives to prevent the recurrence of an unwanted pregnancy in the future.

Reviews about mini-abortion without anesthesia

Kristina Bobrova, 44 years old, Krasnoznamensk, had an abortion during her first pregnancy. The doctor said that the vacuum can be done without pain relief, because the procedure is quick, and I agreed. It was the worst decision in my life - I have never experienced such feelings anywhere else. Giving birth is several times easier. Tatyana Lampova, 26 years old, Kislovodsk A mini-abortion was performed in gynecology without anesthesia: they were told to drink a painkiller and a sedative before the procedure. The doctor promised that it would be painful, but tolerable. Abortion feels like having teeth pulled out without pain relief. Previously, of course, women agreed to this due to the lack of options, but with the modern level of development of medicine, carrying out such procedures is a mockery.

General anesthesia during abortion

Often women ask to use general anesthesia. If hospital policy approves, the doctor may accommodate the patient. But today, not all clinics have the necessary equipment for this (breathing apparatus). Of course, such equipment may not be needed, but if respiratory failure develops after the administration of anesthesia, the lack of equipment can be a cause of death.

In addition, after applying general anesthesia, the woman must stay in the hospital for a long time and be observed by specialists. However, many patients prefer to undergo general anesthesia, since there is a complete lack of perception of the events taking place.

Termination of pregnancy using prostaglandins

Medical abortion is an artificial termination of pregnancy performed by trained medical personnel in compliance with all the requirements of the method. A medical abortion is carried out in a medical institution with the informed consent of the woman and the mandatory registration of appropriate medical documentation. Artificial termination of pregnancy is carried out at the request of the woman up to 12 weeks of pregnancy; for social reasons - up to 22 weeks, and if there are medical indications and the woman’s consent - regardless of the stage of pregnancy.

INDICATIONS FOR MEDICAL ABORTION

At their own request, women terminate their pregnancy at up to 12 weeks upon presentation of a referral from the antenatal clinic, a passport and an insurance policy at an institution operating under the compulsory health insurance program.

For medical reasons, termination of pregnancy is carried out regardless of its duration in the event that pregnancy and childbirth can worsen the woman’s health and threaten her life, or if abnormal development of the fetus is detected. The indications are established by the attending physician, an obstetrician-gynecologist, together with specialists of the relevant profile (therapist, surgeon, oncologist, psychiatrist, etc.

According to social indications, pregnancy termination is carried out at up to 22 weeks. The Decree of the Government of the Russian Federation of August 11, 2003 compiled a list of social indications for induced abortion: a court decision on the deprivation or limitation of parental rights; pregnancy as a result of rape;

a woman's stay in prison; disability of I–II group in the husband or death of the husband during pregnancy. The issue of termination of pregnancy for the listed indications is decided by the commission after the conclusion of the obstetrician-gynecologist at the antenatal clinic on the duration of pregnancy and upon presentation of the relevant legal documents.

If there are other grounds for termination of pregnancy of a non-medical nature, the issue of this termination is decided by the commission on an individual basis. The commission includes the chief physician or his deputy for medical work, the head of the department, the attending physician, as well as specialists: lawyer, psychiatrist, etc.

CONTRAINDICATIONS FOR MEDICAL ABORTION

• Inflammatory processes of the genital organs.
• The presence of purulent foci, regardless of their location.
• Acute infectious diseases.
• Late pregnancy. In later stages, abortion is contraindicated if termination of pregnancy during this period is more dangerous to health and life than continuing pregnancy and childbirth.
• Less than 6 months after previous termination of pregnancy.

PREPARATION FOR ARTIFICIAL INTERRUPTION OF PREGNANCY

Before termination of pregnancy, a preliminary outpatient examination is carried out: collection of anamnestic data; bimanual examination with examination of the cervix in the speculum; determining the degree of vaginal cleanliness; clinical blood test; general urine analysis; determination of blood group and Rh factor; blood test for HIV infection, syphilis, hepatitis B and C;

There are various methods of terminating pregnancy in the second trimester (for medical and social reasons):

• The use of prostaglandins (intra-amnionic, extra-amnionic, parenteral, vaginal).
• Amnioinfusion of hyperosmolar solutions (20% sodium chloride solution).
• Hysterotomy.
• Combined methods.

The tablet that the whole world was talking about, RU 486, or mifepristone, was invented in France by Dr. Etinne-Emile Baulieu in 1980. For the first time, the medicine was introduced in its homeland, and very soon its effect was tested on 4,000 women. Hundreds of scientific studies were conducted in 20 countries, including the CIS. Today, the medication is approved for use only in England (about 6% of all abortions), France (20% of women resort to RU 486), Sweden (17%) and China.

In Ukraine, RU 486 capsules are prohibited for use. The motive is a high percentage of complications, namely: trophoblastic diseases (part of the embryo remains in the uterus).

At a later date, from 13 to 28 weeks, pregnancy is terminated only for medical (listed above) or social reasons. Social indications for termination of pregnancy include:

1. Large families (3 or more children).
2. Death of husband during pregnancy.
3. Divorce during pregnancy.
4. Having a disabled child.
5. Deprivation of maternal rights.

The main way to terminate a late pregnancy is intra-amnial (intrathecal) administration of hypertonic solutions. A technique is used in which a sterile tube with a long needle is inserted into the cervical canal, with which the amniotic sac is pierced, part of the amniotic fluid is released, and then the same amount of hypertonic solution is injected into the amnion cavity. To speed up the termination of pregnancy, the administration of oxytocin and prostaglandins is additionally used.

A study of the long-term consequences of induced abortion showed its negative impact on reproductive function: the possibility of secondary infertility, ectopic (tubal) pregnancy, spontaneous abortion, recurrent miscarriage, endometriosis. Thus, during subsequent pregnancy, a picture of threatening miscarriage is observed in 26.2% of women after a single abortion, with two abortions - in 32.6%, with three or more - in 41.2% of women.

Late complications of abortion include various menstrual dysfunctions: oligomenorrhea, menorrhagia and metrorrhagia. The causes of these conditions are, as a rule, neuroendocrine disorders of central origin (in the pituitary gland and hypothalamus), amenorrhea (lack of menstruation), resulting from endometrial trauma with subsequent inhibition of ovarian function, as well as the development of adhesions in the area of ​​the internal os of the cervical canal, due to its trauma during curettage.

Artificial termination of pregnancy causes a change in the state of the autonomic nervous system, leading to a disruption of the body's adaptive capabilities, which can lead to the development or progression of pre-existing vegetative-vascular dystonia. Often in the months immediately after an abortion, the excitability of the central nervous system increases in women.

The idea of ​​the harmlessness of artificial abortion is far from the truth. When deciding to terminate a pregnancy, a woman is most often guided by personal reasons: family conflicts, difficulties in caring for a child, unsatisfactory living conditions, reluctance to have more than two children, illness of one of the spouses, and currently in our country economic problems are coming to the fore.

Therefore, being the most common obstetric operation, induced abortion can cause damage to a woman’s health that is difficult to repair. The main ways to prevent abortions is the use of reliable and safe methods of contraception (prevention from pregnancy). However, in the event of an unwanted pregnancy, the operation must be performed at the optimal time, always in a medical institution by a highly qualified doctor with adequate pain relief.

Immediately after an abortion, cramping pain in the lower abdomen may occur due to contractions of the uterus to its normal size. This is normal. Painkillers, anti-inflammatory drugs, as recommended by your doctor, will help reduce pain. It is also normal to have slight bleeding from the vagina for a few days, which stops on its own.

However, if after an abortion there is no bleeding, or, on the contrary, it is too abundant and with clots, the body temperature has increased, the pain in the lower abdomen does not stop, you should urgently consult a doctor. When terminating a pregnancy of less than 12 weeks, most women can return to their usual work the day after the abortion, unless of course there are complications. You should follow all doctor’s prescriptions and be sure to visit him after 2 weeks.

Preparing for anesthesia

To use local anesthesia, it is only necessary to exclude an allergy to the drug used. General anesthesia requires more careful preparation. You need to undergo the following examinations:

• ECG;
• general urine analysis;
• general blood analysis.

To avoid serious consequences, you need to prepare your body for the upcoming anesthesia. Alcohol, fatty and spicy foods should be excluded from the diet the previous day. 12 hours before an abortion, doctors ask patients to stop eating and drinking. This is due to the fact that vomiting occurs in rare cases during anesthesia. If stomach contents are allowed to enter the lungs, suffocation (aspiration) will occur.

When the patient regains consciousness, she often experiences severe dizziness and nausea. Vomiting will worsen the already poor state of health after general anesthesia, which is a good reason to refrain from snacking the day before.

Local anesthesia for vacuum abortion

Vacuum abortion is safer (lasts from five to fifteen minutes) and less painful than surgical curettage of the uterus. But this intervention in a woman’s body is carried out only with the use of anesthesia. Most often, local anesthesia is used during this procedure. This method of anesthesia is the most common.

Depending on the drugs that are planned to be used, as well as on the individual characteristics of the patient, the method of administering the drug during vacuum termination of pregnancy can be of two options:

1. The medicine is inserted through the vagina into the uterus. The patient remains conscious throughout the entire process, but she is not in pain during the operation. This method can significantly reduce discomfort, but there is also a certain risk. For example, if the solution accidentally appears in a blood vessel, it can trigger the onset of seizures. However, the likelihood of such a situation is minimal.
2. Intramuscular. The action of the anesthetic prevents pain impulses from passing through the nerve fibers, which will dull the pain symptoms.

After surgery using a local anesthetic, recovery of the body occurs quite quickly and relatively easily, and the risk of any serious complications is reduced to a minimum. However, in some cases, allergic reactions, inflammatory processes and poor health of the woman are observed.

Features of the rehabilitation period

In addition, rehabilitation after a vacuum abortion using local anesthesia is characterized by the following symptoms:

• dizziness;
• nausea;
• chills (usually goes away after a few hours);
• hallucinations and disruption of normal perception of reality (in such cases, the help of an anesthesiologist is necessary);
• memory impairment;
• loss of consciousness;
• changes in blood pressure;
• disruption of the respiratory system (requires additional treatment).

This kind of complications is associated with both the implementation of a mini-abortion and the wrong choice of anesthesia.

I created this project to tell you in simple language about anesthesia and anesthesia. If you received an answer to your question and the site was useful to you, I will be glad to receive support; it will help further develop the project and compensate for the costs of its maintenance.

Negative consequences of abortion

Injuries and bleeding due to injuries to the uterus and blood vessels. This requires urgent surgical treatment, the introduction of hemostatic drugs, and sometimes a transfusion of donor blood and removal of the uterus.

Anesthesia complications: the use of even local anesthesia can lead to failure of the functions of the most important internal organs and allergic shock.

Early complications of abortion include thrombosis and inflammation, including sepsis, blood poisoning, and late complications include the formation of “adhesions” and scarring. These complications arise when an infection acquired during an abortion is not detected in a timely manner, as well as as a consequence of abortive wounds of the uterus, fallopian tubes and cervix. “Adhesions” and scar tissue changes threaten that in the future they can lead to infertility, premature birth, ectopic pregnancy, uterine rupture during pregnancy and childbirth, severe menstrual irregularities, heavy and painful menstruation.

It takes at least six months to restore a woman’s hormonal levels after an abortion. They often resort to prescribing female sex hormones.

Possible complications

Even if the abortion was performed by a qualified specialist, the risk of complications is quite high.

Is it possible to remain pregnant after it?

Since curettage is performed almost blindly, there is a risk of incomplete removal of the fertilized egg. In this case, severe bleeding begins, abdominal pain, chills, and weakness are noted. Bleeding and pain may also indicate injuries to the genital organs and violations of the integrity of the walls of the uterus (perforation).

No less dangerous are the late consequences of surgical abortion, such as:

• irregularities in the menstrual cycle;
• formation of adhesions;
• obstruction of the fallopian tubes;
• the appearance of benign tumors in the uterus as a result of a hormonal imbalance;
• miscarriage, miscarriages, premature births in subsequent pregnancies;
• secondary infertility;
• psycho-emotional disorders, depressive states.

Every woman who decides to have such an operation must remember that she is risking her health and the health of her future children. Curettage is especially dangerous when it is the first pregnancy. The likelihood of negative consequences increases if there has already been a history of termination of pregnancy, in the presence of inflammatory diseases of the genital organs, or in previous operations on the uterus or ovaries. Women who have had several abortions in their youth have a significantly increased risk of developing genital cancer during menopause.

Minor caesarean section

Some women are indicated for immediate delivery. In this case, a minor caesarean section is performed under general anesthesia. The anterior wall of the abdominal cavity and the anterior wall of the uterus are sequentially opened, the fetus and surrounding tissues are removed, and the uterine cavity is scraped out.

A vaginal cesarean section is possible. The operation is performed through a vaginal approach, dissecting the lower segment of the uterus.

A complication of this method is the development of postoperative infections.

Some features

Depending on the duration of use of this drug, there is a possible decrease in the level of hemoglobin in the blood, as well as various types of neurological disorders. This drug is called “laughing gas”. For some time it was illegally popular as a drug in America and Europe. It is also known that they manage to sell it today. However, it should be borne in mind that uncontrolled use of laughing gas may well lead to an overdose, which in turn provokes breathing problems, interruptions in heart rhythm, complete cardiac arrest and death.

An anesthetic such as halothane is a gaseous agent with a characteristic sweet odor. Halothane has adverse effects on the liver and heart and can cause hepatitis and serious heart problems.

Inhalation drugs such as sevoflurane, isoflurane, desflurane belong to a new generation and are considered safer and more advanced drugs, which have an almost complete absence of side effects and contraindications. The only pathology detected after their use is considered to be the possibility of malignant hyperthermia, which is a life-threatening condition of the human body that appears only as a result of exposure to drugs.

Non-inhalational anesthetics such as ketamine, propofol, etomidate, midazolam and thiopenal are used for sedation and various types of anesthesia during abortion. In addition, opioids are widely used.

Drugs in this group include morphine, codeine, trimeridine, fentanyl, tramadol, nalfubin, and so on. All of the above drugs have a number of side effects, which are expressed to varying degrees depending on which group the drug belongs to. At the moment there are two of them: narcotic and non-narcotic.

Medicines of the second subgroup, like any drugs, cause addiction. The effect during surgery is much stronger from narcotic analgesics, however, when using them, the frequency of use and the degree of impact on the body should be taken into account. The dose indication and manipulations are carried out under the close supervision of the attending physician. Under normal circumstances, the risk of drug addiction in the future is eliminated.

In any case, abortion under general anesthesia is considered the most optimal and comfortable option.

However, it should be done with the obligatory connection of a device for artificial ventilation of the lungs, which is not always available due to the lack of necessary equipment. For this reason, the appointment is made based on capacity, which involves performing an abortion under sedation.