Abortion is the termination of pregnancy in the later stages for medical reasons. Termination of pregnancy for medical reasons in the later stages: how and where can you get an abortion? Termination of pregnancy for medical reasons where to do
Termination of a late pregnancy is an unpleasant procedure, regardless of its cause. Understanding the severity of the consequences for the physical health and psyche of a woman, doctors carry out this procedure only in emergency cases.
Diagnosis before abortion
Termination of pregnancy in the later stages in most cases is associated with medical indications. If at an early stage (up to 12 weeks) an abortion can be performed simply at the request of a woman, then in more late period a gynecologist rarely decides on surgery without appropriate indications and supporting documents.
The complex of diagnostic measures includes:
- examination on a gynecological chair;
- smears from the vagina, cervical canal and urethra;
- bacteriological culture from the cervical canal;
- general and biochemical blood tests;
- blood test for antibodies to hepatitis, HIV infection;
- blood test for syphilis;
- determination of blood group and Rh factor;
- X-ray or fluorogram of the chest;
- ultrasound examination of the pelvic area;
- Analysis of urine;
- therapist consultation;
- consultations of related specialists who have identified a pathology of fetal development or mother's disease.
A specially created commission, consisting of a gynecologist, related specialists and the head physician, decides on the termination of pregnancy after studying the patient's history. The commission also decides what type of abortion will be performed: in each case, the choice is made in favor of the least traumatic method.
After examining the reason for the termination of pregnancy, the data of the diagnostic examination, in the absence of contraindications, the commission issues a permit for an abortion and sends the patient to a medical institution.
Until the 22nd week of pregnancy, its termination is carried out in an abortion clinic located in the gynecological department of a medical institution. Over 22 weeks, surgery is performed only in an obstetric hospital.
Late pregnancy termination is always a risk not only for a woman's reproductive health, but also for her life.
The course of the operation and the rehabilitation period depend not only on the type of surgical intervention, but also on the individual characteristics of the patient's body.
Reasons for late abortion
The main reasons why women decide to terminate a pregnancy at a later date include:
- medical indications: severe anomalies in the development of the fetus or diseases of the mother that threaten her health and life;
- social indications: deprivation of parental rights, pregnancy as a result of rape.
The issue of the possibility of termination of pregnancy for a period of 12 to 22 weeks is decided by an expert commission. At the request of a woman alone, an abortion is not done at this time. After 22 weeks, artificial termination of pregnancy is also not carried out. In this case, the child born into the world is considered a newborn, and he needs special care and medical attention.
More about the causes of late-term abortion:
- Anomalies of intrauterine development, hereditary genetic diseases, chromosomal disorders are the main cause of late pregnancy termination.
- Viral infectious diseases, transferred by a woman in early pregnancy, can cause a child's disability and the development of congenital deformities that are incompatible with life. Of particular danger to the fetus are diseases such as rubella, toxoplasmosis, hepatitis, HIV infection. Bacterial infections are no less dangerous than the antibiotic therapy prescribed to eliminate them.
- Fetal fading (regressive pregnancy) at any time is a direct indication for its termination. This pathological phenomenon is very dangerous for a woman's life. The risk of sepsis and bleeding requires immediate removal of the dead fetus from the uterine cavity.
- mental illness diagnosed in a pregnant woman can cause a late abortion in case of complete inadequacy of the expectant mother or lack of support from relatives.
- Rape is also a reason for late pregnancy termination. In rare cases, a woman decides to keep the child.
- The decision to terminate a pregnancy at a later date may be caused by unfavorable social and living conditions for the unborn baby. These include: a woman's stay in places of deprivation of liberty, the deprivation of the mother of parental rights, the death of the child's father, and other circumstances.
Despite the above reasons, many women decide to have a late abortion only as a last resort. Support from loved ones helps to avoid an unpleasant procedure.
Ways to terminate a pregnancy at a later date
After 12 weeks, abortion is considered late. The maximum period for artificial termination of pregnancy is 22 weeks.
Termination of pregnancy can be medical or instrumental.
Medical methods
Instrumental methods
To prepare the cervix for abortion, the following methods are practiced:
- Introduction to the cervical canal of seaweed sticks(kelp) a day before a planned termination of pregnancy contributes to the expansion of the cervix by increasing the size of algae when absorbing amniotic fluid.
- Dilation of the cervical canal with the help of Hegar dilators, they are used from the 15th to the 28th week of pregnancy. The higher the gestational age, the more instruments will be used to dilate the cervix.
After dilating the cervix and opening the fetal bladder, the fetus is removed by the legs using Muso forceps. This method is very traumatic, time-consuming, threatens with tissue ruptures and secondary infection. To reduce trauma to the uterus, an incision is made in the fetal neck and a tube is inserted deep into the skull. The brain is then aspirated using a vacuum apparatus. As a result of the manipulations, the head decreases in size and freely passes through the vagina.
Possible Complications
Termination of pregnancy at a later date threatens the development of various complications:
- infection of the wound surface with pathogenic flora;
- infection of the ovaries and fallopian tubes (salpingitis and salpingo-oophoritis);
- in reproductive and neighboring organs;
- development of sepsis;
- uterine bleeding;
- perforation of the body of the uterus;
- thrombosis of blood vessels;
- pulmonary embolism;
- incomplete removal of the placenta or parts of the fetus;
- violation of the natural hormonal background;
- hypernatremia;
- infertility;
- miscarriage in the future;
- severe psychological trauma.
To minimize the risk of complications, it is necessary not only to choose a highly professional specialist for abortion, but also to follow his recommendations in the postoperative period:
- careful intimate hygiene;
- lack of sexual intercourse until the wound surface is completely healed;
- bed rest until the body recovers after surgery;
- a ban on lifting weights;
- antibacterial and anti-inflammatory therapy prescribed by the attending physician;
- regular visits to the gynecologist;
- consultation of a psychologist (psychotherapist);
- consultations of related specialists who observed the woman during pregnancy;
- immediate appeal for qualified help to a medical institution in case of any alarming symptoms;
- adequate contraception after an abortion.
Despite the reason why a woman decided to have a late abortion, one must understand the danger of the manipulations being carried out. Preventing unwanted pregnancies with contraceptives will reduce the sad statistics of abortions at any time.
Termination of pregnancy in the later stages can only be carried out if there are good reasons. Late abortion means abortion in the second and third trimesters.
What do you need to know?
According to the law, termination of pregnancy at the initiative of the woman herself is possible strictly up to 12 weeks, that is, in the early stages. Thus, 3 months is the latest term for terminating a pregnancy.
The sooner the abortion is performed, the less negative consequences for the woman's body and the development of any complications.
Termination of pregnancy after 12 weeks refers to termination in the later stages. The operation is possible in three cases:
- Fetal pathologies.
- Pathologies that are dangerous to the health and life of a woman.
- social factor.
If there are social reasons, termination of gestation is done up to 6 months, for medical reasons - at any month. The decision to have an abortion or not, for a long time, is always up to the woman. But the doctor should convey to the pregnant woman all the information why an abortion is required and what are its possible consequences.
Dilatation and curettage of the uterus
The method used to stop gestation in the 2nd and 3rd trimesters. It is based on the use of a curette - a surgical knife, which is used instead of a vacuum aspirator.
Simply put, curettage is the curettage of the uterine cavity in order to extract the fetus.
The operation has a high risk of injury and perforation of the walls of the uterus.
Artificial childbirth
The call of artificial childbirth is used for periods of 25-32 weeks. Drugs are injected into the body that cause uterine contractions.
The woman stays in the clinic after the procedure for up to 4 days. The method is appropriate in cases of intrauterine fetal death.
Hysterotomy
The method of extracting the fetus by making an incision in the wall of the uterus through the abdominal cavity. It is carried out up to 24 weeks of pregnancy, later - this is already a caesarean section.
Often performed when it is impossible to extract the fetus in other ways.
On the video about abortion methods:
Possible consequences
Late surgery has a serious negative impact on the woman's body, since it has already undergone hormonal changes aimed at gestation and childbirth.
Possible complications after an abortion in the later stages:
- trauma to the uterus;
- infectious process as a result of the remains of the embryo in the uterine cavity;
- purulent complications;
- uterine bleeding;
- - growth of the endometrium outside the uterine cavity;
- endometritis - inflammation of the endometrioid tissue in the uterus;
- violation menstrual cycle;
- violation of the ovaries due to hormonal failure.
Subsequently, it is possible:
- secondary infertility;
- the appearance of adhesions in the pelvic organs;
- urinary tract infections.
Recovery period
Long-term abortion is the strongest stress for a woman, both in terms of physical health and psychological.
For the speedy recovery of the body, the doctor gives recommendations:
- refusal of sexual activity within a month after the operation;
- lack of physical activity;
- refusal to use hygienic tampons;
- taking vitamin and mineral complexes;
- protein diet;
- temperature, pulse rate and blood pressure control;
- control of vaginal discharge.
In addition, after the intervention, a woman is prescribed a number of drugs - antibacterial and hormonal, which must be taken strictly according to the prescribed scheme.
Termination of pregnancy in the later stages is unacceptable only at the request of a woman. For this, there must be serious medical or social indications. If you had to have an abortion, it is important to follow all the doctor's recommendations after the procedure and carefully monitor the condition of your body.
Termination of pregnancy at the request of a woman can be carried out only up to the 13th week of gestation. Late abortion is allowed only for social or medical reasons. The later such an intervention is carried out, the more likely the occurrence of complications. Are there any contraindications to the operation? How to prepare for it and protect the body from negative consequences as much as possible?
Indications for termination of pregnancy in the later stages
Late abortion is the removal of the fetus, carried out from 12 to 20 weeks. Some doctors move the period up to 28 weeks, which corresponds to the third trimester. A later intervention is called an artificial birth. In order to terminate a pregnancy in the later stages, only the desire of the mother is not enough. Since 2012, only one social reason for abortion has been identified - the onset of conception as a result of rape. Previously, the list was wider. The list was reduced by law due to the severe consequences for the woman's health.
Medical indications are approved by the medical commission. Factors for which doctors recommend abortion include:
- late detected pathologies of the fetus (genetic diseases, abnormalities in the formation of organs);
- diseases of the mother, in which the bearing of the baby threatens her health (diabetes mellitus, heart disease, kidney disease, genitourinary system, poor blood clotting);
- the influence of the pathogenic environment on the embryo (physical trauma of the fetal bladder, chemical, radiation exposure);
- frozen pregnancy;
- severe illnesses transferred during the gestation period (carcinomatosis, rubella, tuberculosis, syphilis), treatment with cytostatics, antibiotics;
- somatic, psychiatric diseases of a woman.
One doctor does not have the right to decide on the need to terminate a pregnancy. The council should include at least the gynecologist who supervised the pregnant woman and the head physician of the antenatal clinic. The impossibility of further gestation is documented by the results of the tests, ultrasound, screening tests. The final decision rests with the pregnant woman. Without her consent, an abortion is possible only if there is a threat to her life.
Contraindications for abortion
Due to the fact that termination of pregnancy after 12 weeks is associated with a threat to the health of the woman or pathologies of fetal development that are incompatible with life, the existing contraindications are considered individually. Common factors include:
- blood clotting disorder;
- venereal and other STDs;
- acute inflammatory process of the genitourinary system;
- taking corticosteroids, hormonal drugs for a long time;
- exacerbation of chronic diseases;
- Rhesus conflict in previous pregnancies.
If there are contraindications, a woman can still insist on surgery. The task of the gynecologist is to explain the possible consequences of the procedure. Some contraindications become a reason for postponing an abortion to a later date.
Preparing for the operation
Since late termination of pregnancy is carried out for medical reasons, the pregnant woman must be fully examined. In addition to a gynecological examination, you will need a conclusion from a narrow specialist: genetics, cardiologist, endocrinologist.
Preparation includes such standard tests as a clinical and biochemical analysis of blood, urine, a test for HIV, syphilis, the presence of antibodies to hepatitis. A smear is taken to determine the microflora of the genital tract, STDs; material is collected for bacterial culture of secretions from the urethra, cervical and cervical canals. A complete examination will assess the patient's health status.
For a late abortion, additional diagnostic measures may be needed - cardiography, ultrasound examination of internal organs, urography, fluorography. If genetic pathologies are suspected, a puncture of the fetal bladder is performed to puncture the amniotic fluid. The woman signs the consent to the operation before admission to the hospital.
Ways to terminate a pregnancy in the later stages
In the later stages, abortion is carried out only in specialized medical institutions, where conditions for inpatient stay are provided. Depending on the timing, there are several options for surgical intervention.
At the end of the first - beginning of the second trimester, a forced dilation of the cervix is made and the fetus is removed with forceps. The tissue remains are removed with a vacuum tube. The operation takes about half an hour.
From the 18th week, curettage (curettage, abrasion) is done. The woman is placed under general anesthesia. Tools or medications expand the cervix. Possible introduction chemical substances to stop the fetal heartbeat, soften tissues. The fetal egg is scraped off the walls of the uterus, sometimes cut into several parts with a surgical instrument. The procedure of curettage is fast, it takes about 20 minutes. However, complications are likely in the form of infections, mechanical damage to the uterus, tubes, and bladder.
In some countries, women at 6-8 months of pregnancy undergo a partial birth operation, in which the fetus is removed from the womb, having previously been killed. The fetal place is sucked out by vacuum. The moral, ethical aspect of the procedure causes a lot of controversy. In Russia, this method is prohibited.
From 20 to 27 weeks, a so-called saline abortion, or early artificial birth, can be performed. This is a painful and very dangerous procedure for the mother. A concentrated saline solution with glucose is injected into the amniotic fluid. The fetus dies inside the womb from dehydration, a chemical burn. After 1-2 days, labor activity begins. The dead fetus is removed from the uterine cavity.
If the life of a pregnant woman is at risk, a small caesarean section is performed for a gestation period of more than 25 weeks. The operation consists in cutting the abdominal and anterior walls of the uterus. Through the incision made, the fetus is removed, the walls of the uterus are scraped out.
Consequences of abortion
The later the gestational age at which the fetus is removed, the more difficult the operation is tolerated. Curettage of the uterine walls can negatively affect the further reproductive abilities of a woman. As a result of artificial expansion of the cervix, injuries occur on it. In subsequent pregnancies, they will need to be sewn up. Damage to the tissues of the endometrium leads to the appearance of scars, disruption of the menstrual cycle.
The introduced infection causes adhesions. It is dangerous infertility, ectopic pregnancies in future. Aggressive scraping with surgical instruments can result in a puncture of the uterine wall. In case of significant damage, the uterus can be removed. With the second and subsequent abortions, the uterus contracts poorly. This causes severe internal bleeding, a lot of blood loss.
Complications are unpredictable and may occur in the postoperative period, even with a skilled procedure. Abortion in the later stages is difficult to survive psychologically. Usually a woman is already expecting a baby, but is forced to terminate the pregnancy for medical reasons.
A month and a half after the operation, bloody discharge from the vagina continues. During this period, you can not take a hot bath, go to the sauna or bath. Heat may cause bleeding. It is advisable to limit sexual intercourse until the menstrual cycle normalizes. A few weeks should be avoided significant physical exertion.
You can support the body by taking vitamin complexes. You should increase the amount of protein consumed. To prevent infection, you can not use tampons, swim in open water. Perhaps the appointment of a doctor of antibacterial and hormonal drugs. For at least six months after an abortion, the woman's genitals are not ready for a new pregnancy. Reliable methods of contraception should be used.
In case of chromosomal abnormalities or fetal death, a genetic examination will be required before conception is planned. For those who have had an abortion, it is important to monitor their health, visit a doctor regularly and follow his recommendations.
Pregnancy does not always proceed joyfully and cloudlessly, as we would like, there are often cases when it needs to be interrupted for a long time. It should be noted that no one will have an abortion simply out of "wish" in the later stages. According to existing legislation, pregnancy for a period of more than twelve weeks can only be terminated for existing medical or social reasons.
Termination of pregnancy after 20 weeks is accompanied by an extremely high risk to the health and life of the mother. On the other hand, abortion at such times can be equated with murder, since the fetus is viable by this time. In such situations, a woman must have very weighty arguments in order to decide on such a step.
Indications for late abortion.
The decision to terminate a pregnancy in the later stages can be based on medical and social reasons. The first group of indications includes a serious deterioration in the general health of the mother against the background of complications. diabetes available serious illness blood, heart and blood vessels, central nervous system, various kinds of tumors that require immediate therapy. In addition, an indication for late abortion is the identification of chromosomal abnormalities in the fetus, malformations that interfere with its further normal development or provoke its death, as well as if there is a risk of genetic diseases. I must say that some infectious diseases can lead to abortion. In these situations, abortion is the only salvation for mother and child from future suffering.
In order to obtain documentary permission for a surgical operation to stop intrauterine development of the fetus in the later stages of a pregnant woman, it is recommended to contact an obstetrician-gynecologist at the place of observation, who will issue it after the examination and tests, as well as after the exclusion of any contraindications to its implementation. Based on the results of the tests, the general health of the woman and the degree of abnormalities in the development of the fetus are assessed.
It also happens that a woman, due to physiology, did not immediately determine that she was pregnant, or she made a mistake when calculating the gestational age (sometimes it happens that menstruation continues for several months after fertilization), or she did not immediately tell this news to her lover or loved ones, therefore, the decision to terminate is made at a later date. It is for such cases that there is a second group of indications for abortion - social. This group of reasons should also include extremely unpleasant situations when the husband or father of the unborn baby suddenly dies in a pregnant woman, when this pregnancy is the result of rape, or when the expectant mother is in “places not so remote”. Deprivation or restriction of parental rights, as well as disability of the first and second groups can also serve as a serious reason for carrying out an artificial termination of pregnancy at a later date. In each specific case, a special commission of doctors at the place of observation of the pregnant woman is considering the issue.
It should be noted that, despite the presence of a significant social or medical indication for late abortion, in the presence of inflammatory diseases of the female genital organs in an acute form, inflammatory processes in an acute form and infectious diseases in an acute form, such surgical intervention is not permissible.
Pre-abortion examination.
Before the abortion operation, an ultrasound of the fetus and uterus is prescribed, the blood group and Rh factor are determined, a blood test is done for HIV, syphilis, hepatitis, a hemostasiogram, a biochemical blood test, urine, smears from the urethra, cervical canal and vagina are examined, antibodies are determined to hepatitis C, a chest X-ray, and an examination by a general practitioner and other specialists, if necessary.
If there are social or medical reasons for terminating the pregnancy, the woman is issued with a certified conclusion outlining the full clinical diagnosis with the signatures of specialists and the seal of the institution. If a woman is diagnosed with mental and venereal diseases, the documents are transferred to an obstetric and gynecological institution. In the absence of medical contraindications, a woman is given a referral to a medical institution, where the gestational age, the results of the examination, the conclusion of the commission (diagnosis) and social indications are indicated.
Since late abortion is associated with many risks, this operation is performed using painkillers in a hospital setting and only by specialists with special training. At the end of the surgery, an ultrasound is performed to accurately assess the result (check whether all parts of the fetus and placenta are removed).
Methods for terminating a pregnancy at a later date.
Taking into account the gestational age, the doctor selects the appropriate method of abortion. The least number of complications gives termination of pregnancy for a period of no more than 21-22 weeks, and in general, abortion is possible up to 27 weeks.
Cervical dilation and fetal extraction is performed between 12-20 weeks of pregnancy. A vacuum aspirator is introduced into the uterus, through which the fetus and fetal membrane are removed in parts. With this technique, there is a high risk of injury to the uterine wall, which results in severe bleeding, often resulting in death.
Another method used to terminate a pregnancy at 20-28 weeks is vaginal fluids (one of the artificial birth methods). Having expanded the cervix, a small amount of fetal fluid is sucked out of the fetal bladder using special instruments, after which the same volume of a highly concentrated solution of salts and glucose is injected into the uterus. As a result, the fetus dies, and after a day and a half, the woman starts contractions, and the dead fetus is rejected by the body (a kind of miscarriage occurs). On average, such an abortion occurs within thirty hours.
In rare cases, kelp sticks are injected into the cervical canal to induce labor. If in this case the contractions do not begin, special substances-stimulants of labor (prostaglandins, oxytocin, antispasmodics) are introduced.
Very rarely, but in the presence of medical contraindications with simultaneous medical or social indications for late abortion, a small caesarean section is performed. During such an operation, surgeons open the anterior abdominal wall and the anterior wall of the uterus, then the fetus and surrounding tissues are removed from the uterus, and the uterine wall is scraped. As a result of using this technique, the fetus may be alive, but no resuscitation is applied to it, and it dies.
Complications after late abortion.
- Incomplete cleansing of the uterine cavity from fragments and parts of the fetus with the addition of infection.
- placental polyp.
- Hematometer.
- Ruptures of the cervix.
- perforation of the uterus.
- Diseases of purulent-inflammatory course.
When the happiness of a pregnant lady is overshadowed by a formidable verdict of doctors, she has to decide on a serious step - an abortion for medical reasons. Such an interruption of gestation by an artificial method is carried out in two cases - if gross malformations are detected in the baby or if a woman has diseases that are incompatible with pregnancy. Depending on the period, the procedure is carried out by various methods, and the procedure takes place only in a hospital setting. Consider the official medical indications for abortion, what complications can occur and how to survive the "post-abortion syndrome"?
For medical reasons, pregnancy can be unplanned to stop at any time. The method of interruption is closely related to the gestational age.
Until the end of the 1st trimester, the so-called early interruption is undertaken. It is noteworthy that during the first trimester a woman has the right to request an abortion even without strong evidence. Taking into account the term and condition of the woman, the obstetrician will select the optimal method of interruption - instrumental or medical abortion.
After 12 weeks, a late termination of pregnancy is carried out for medical reasons. Between 12 and 22 weeks, various methods of interruption can be used, after 22 gestational weeks - only artificial stimulation of delivery.
The method of interrupting gestation depends not only on the term, but also on the clinical picture, the qualifications of the obstetrician-gynecologist, his experience and the technical base of the clinic.
Specialized medical institutions terminate pregnancy by the following methods:
- Medical interruption. Taking drugs that provoke a miscarriage is allowed for up to 6 weeks. It is the least harmful option for abortion.
- Vacuum aspiration. The safest option is abortion, which can be performed before 12 weeks of gestation. After 12 weeks, dilatation with embryo evacuation is practiced. The essence of the procedure is the mechanical expansion of the cervical passage and pumping out with the help of a vacuum installation of the fetus. The process takes place under strict ultrasound control. This eliminates trauma to the uterus. The woman is under anesthesia during the operation. The duration of the procedure is from 40 minutes to several hours.
- Curettage. A more traumatic option for removing the fetus from the uterus. It is carried out up to 12 weeks in case of ineffectiveness of taking abortive drugs or vacuum aspiration. Also, curettage can be carried out at a later date, if the gynecologist considers this option productive. The essence of the operation: using a curette (medical instrument), the obstetrician-gynecologist scrapes the upper layer of the uterus, capturing the embryo along with it. The method has many disadvantages, including a high probability of damage to the uterus, problems with subsequent conception and gestation.
- Artificial childbirth. If the woman is over 22 weeks and the fetus weighs more than half a kilogram or has no signs of life, it is advisable to induce labor so that the fetus comes out naturally. This eliminates possible complications after interruption by other methods.
- Hysterotomy. Used in emergencies. A cavity incision of the uterus is performed, followed by extraction of the fetus. After 24 weeks of pregnancy, it is considered a full caesarean section. It is used in cases where other methods have not given a positive result.
Legal aspects of abortion for medical reasons
Performing an abortion according to medical indications is a complex procedure not only from a medical, but also from a legal point of view. The decision to carry out the procedure is made on the basis of the current laws of the Russian Federation. Indications for termination of pregnancy contain an order dated December 3, 2007, as amended on December 27, 2011.
If a disease is confirmed in a pregnant woman that serves as a reason for interruption, the gynecologist convenes a council of doctors, at which a complete examination of the pregnant woman is carried out. If pathological processes in the body that are incompatible with the further bearing of the baby are confirmed, an appropriate document is drawn up with a seal. It is he who serves as the basis for the termination of pregnancy.
A woman, according to the law, should be aware of her condition, possible risks in case of refusal to have an abortion. The pregnant woman must consent to the procedure or deliberately refuse it. Without this, abortion is prohibited. If a woman is in a serious condition, permission or refusal to have an abortion is signed by the next of kin.
Artificial termination of pregnancy - medical indications
The decision to terminate prematurely is made when a woman's life is in danger or it has been established that the fetus has medical genetic disorders that, after birth, will lead to lifelong disability.
Medical indications for termination of pregnancy: diseases of a woman
According to the law, abortion for medical indications is carried out in the presence of the following pathologies:
- Age up to 15 years.
- Tuberculosis: all active forms.
- Rubella: primary infection in the first trimester.
- Malignant oncological diseases, the treatment of which requires chemotherapy or radiation therapy to the pelvic organs.
- Diabetes mellitus: with severe nephropathy, after kidney transplantation, with progressive diabetic retinopathy.
- Burnet's syndrome in severe form and active phase.
- Acromegaly in the active phase.
- Prolactinoma (in case of resistance to dopamine agonists and chiasmal disorders).
- The active phase of Itsenko-Cushing's syndrome.
- Primarily diagnosed acute leukemia.
- myelodysplastic syndromes.
- Lymphomas at high risk.
- Hodgkin's disease stage 3-4.
- Chronic myeloid leukemia: in the terminal stage or requiring therapy with tyrosine kinase inhibitors.
- Chronic myeloproliferative diseases in the final phase.
- Severe form of aplastic anemia.
- Hemolytic anemia, accompanied by acute hemolytic crises and severe recurrent course.
- Chronic, constantly relapsing course of Werlhof's disease, which is unresponsive to any type of treatment.
- Porphyrin disease: an acute attack occurring less than 2 years after the last exacerbation.
- Mental disorders: chronic and protracted, hereditary and degenerative, caused by the use of psychoactive drugs, affective and severe psychogenic disorders.
- Inflammatory diseases of the CNS.
- Severe course of Huntington's disease.
- Severe course of Charcot's disease.
- Severe forms of parkinsonism.
- Generalized handicaps of dystonia.
- Progressive course of multiple sclerosis.
- Severe epilepsy.
- Acute disorders of cerebral and / or spinal circulation.
- Narcolepsy, catalepsy.
- Damage to the nerve roots and plexuses.
- Severe Guillain-Barré syndrome.
Important! In case of refusal, the woman takes responsibility for her life, as well as the health of the unborn baby.
List of medical indications for abortion: fetal pathology
List of indications for medical interruption with irreparable pathologies of the fetus:
- Ascertaining the intrauterine death of the baby.
- Detected genetic anomalies in the development of the fetus.
- Physical deformities of the fetus incompatible with life after birth.
When the above anomalies are detected, a number of additional tests and studies are carried out to make sure the diagnosis is correct. After that, the woman is explained the expediency of an abortion, and with her consent, the pregnancy is terminated.
Social indications for abortion
According to the order of the Ministry of Health of the Russian Federation, a woman has the right to independently make a decision to terminate a pregnancy for up to 12 weeks of gestation. After this period, she must have strong medical indications, which are documented during the examination.
But there is another reason for interruption - the social factor. Thus, a decree of the government of the Russian Federation gives a woman the right to consult a doctor for subsequent termination of pregnancy up to 21 weeks in case of conception that occurred as a result of rape. In this case, the interruption is carried out within the framework of the state health insurance program.
Late termination of pregnancy: medical indications, contraindications, complications
Late is called interruption at the 2nd, 3rd trimester of gestation. Indications for abortion are the same as in the early stages - fetal deformities, severe illness of the pregnant woman, incompatible with pregnancy, taking teratogenic drugs, transferring viral infections that disrupt the development of the fetus (rubella), etc.
Late termination of pregnancy for medical reasons may be undesirable due to the woman's contraindications:
- Rhesus conflict.
- Pathology of blood clotting.
- Exacerbation of infection of the genitourinary system, including the development of STDs.
- Long-term corticosteroid therapy.
To ensure the safety of abortion in the 2nd and 3rd trimesters, the woman is carefully examined. Be sure to conduct an analysis for the definition of genital infections, a clinical blood test, biochemistry indicators, ultrasound, a cardiogram. If the cause is a genetic abnormality in the fetus, the amniotic fluid is examined to confirm the diagnosis.
It is known that the earlier the interruption occurs, the less complications there will be. For this reason, late interruption for medical reasons is carried out with great care. But this does not exclude the risk of developing negative consequences for a woman, namely:
- damage to the uterus;
- infection of the uterus and appendages as a result of incomplete extraction of the fetus;
- endometritis;
- adhesive process;
- hormonal dysfunction;
- endometriosis;
- secondary infertility.
Important! Given the large list of complications, a future pregnancy after an interruption for medical reasons may not go as smoothly as we would like. Therefore, pregnant women with a honey abortion in the past should be under the close care of a doctor.
How to survive a medical abortion
When you have to consciously abandon an unborn, but already dearly beloved baby, a woman plunges into a state of extreme stress. This is a real test for her and her loved ones. How to cope with this pain of loss and find the strength to live on?
- To begin with, realize that without a personal desire to experience it, you will not succeed. After all, it is impossible to help a person who does not want it. Open up to your loved ones, accept their support.
- Now you need to accept the fact that you agreed to the interruption. You should not blame yourself for something, because the circumstances with this pregnancy did not depend on you. Finally accept the fact that you are not to blame for what happened, and forgive yourself. Without this step, all further actions will be in vain.
- Another effective method will help: try to speak out. A psychologist, a friend, a husband can listen to you. Most importantly, do not fight with memories alone. It does not hurt to be in comfortable conditions - in the park, in the theater, at a cultural event.
- Pay special attention to health. Be sure to take a rehabilitation course prescribed by an obstetrician-gynecologist. Also take steps to prevent pregnancy in the next 2-3 months.
Termination of pregnancy for medical reasons - reviews
Most cases of forced termination of pregnancy occur due to the formation of malformations of the baby. Women who experience this experience depression, blaming themselves for what happened. Doctors call this condition "post-abortion syndrome." Many women need to correct their psycho-emotional background with the participation of a psychologist, but some cope with the help of loved ones.
As for complications after the procedure, women often note a short-term hormonal imbalance, which is manifested by an irregular cycle, abnormal discharge, and problems with conception. But properly formulated treatment allows you to normalize reproductive function.
No matter how hard it is, stay positive. Of course, the forced termination of a desired pregnancy is very difficult to survive, but you have another pregnancy ahead of you and a long-awaited meeting with your baby. Therefore, try to come to this moment in good health and good spirits.