Abortion is an artificial termination of pregnancy for up to 22 weeks. Currently, there are several methods of abortion, which are used depending on the period:
- Vacuum abortion or mini-abortion (up to 6 weeks) - extraction of the ovum by vacuum suction,
- Medical abortion (up to 7 weeks) - made with the help of drugs (mifepristone, pencrofton), which provoke a miscarriage,
- Surgical abortion (from 4 to 22 weeks) is an operation during which the doctor scrapes the uterus and removes the ovum.
Read more about the types of abortion in another article.
Any abortion, as a serious medical intervention, inevitably carries with it the risk of complications. Some negative consequences and complications of abortion may be characteristic of a particular method of abortion.
For example, in medical abortion - slight abdominal pain, nausea, vomiting, headaches, dizziness, chills, fever, uterine contractions. In 1-2.5% of cases with medical abortion, pregnancy is not interrupted, up to 7.5% of cases incomplete abortion occurs, in this case curettage is additionally performed.
With vacuum abortions, the risk of incomplete release of the ovum is higher than with drug-induced abortions. In addition, violations of the menstrual cycle with a mini-abortion more serious.
The most dangerous type of abortion is scraping (surgical abortion), because it is the most traumatic. With surgical abortion, damage to the uterus is possible with surgical instruments.
The risk of complications is markedly reduced if the method of abortion is chosen taking into account its duration.
Complications arising after an abortion are divided into two groups: early and late.
Early effects of abortion
Early complications develop during or immediately after an abortion.
Discharge after abortion. The bleeding that occurs after an abortion usually lasts up to a week and is somewhat more abundant than the usual menstruation. In some cases, weak bleeding lasts up to a month.
It is necessary to pay attention to the presence of impurities in the discharge after an abortion, their color and smell. This will make it possible to suspect a developing complication in time and take action.
It is also important to control the amount of blood loss. If after an abortion, the discharge is too abundant (two Maxi gaskets are consumed per hour), you should immediately see your doctor, because this may indicate incomplete abortion. The appearance of smell can talk about infection.
The first day of abortion is considered the first day of the cycle. Normally, menstruation begins 3 weeks after an abortion, within a few months, a certain cycle shift is allowed (up to 10 days).
Perforation of the uterus - One of the most serious complications of abortion. During the operation, a rupture of the uterine wall by inserting instruments occurs. The risk of this complication increases with the duration of pregnancy. Perforation of the uterus requires immediate surgical treatment, and in severe cases, surgical removal of the uterus is necessary. In addition, during perforation of the uterine wall, the intestines, bladder or large vessels may be damaged.
Sometimes there is a rupture or incision of the cervix. These effects can significantly reduce the likelihood of pregnancy after an abortion, or even lead to infertility. With subsequent pregnancies, gestation is difficult, high risk of uterine rupture during childbirth.
Heavy bleeding - occurs when large vessels are damaged, with uterine myoma, or after multiple births. Requires urgent therapy, in severe cases, make a blood transfusion. If it is impossible to stop bleeding, the uterus is removed, since prolonged blood loss can lead to the death of a woman.
Incomplete abortion - sometimes during an abortion the fertilized egg is not completely removed. In this case, bleeding develops, abdominal pain occurs, and chronic inflammation of the uterus, endometritis, may develop. When this complication is repeated abortion, the remnants of the ovum are removed.
Infection penetration in the uterus during surgery can cause inflammation and exacerbation of diseases of the pelvic organs - endometritis (inflammation of the uterus), parametritis (inflammation of the circulatory tissue), salpingitis (inflammation of the fallopian tubes). In severe cases, sepsis can develop - blood infection. This condition is very dangerous for life, and requires urgent treatment with antibiotics.
Late complications after an abortion can occur months, and even years after surgery. These are chronic inflammatory diseases, adhesive processes, hormonal disorders and disorders of the organs of the reproductive system.
During pregnancy, large-scale hormonal and physiological alterations occur in the body of the woman, which ensure gestation, prepare the body for birth, feeding, etc.
Abortion is a strong stress for the body, in which the hormonal system is primarily affected.
- when after abortion, menstrual periods become irregular, with frequent delays - a very common problem, it occurs in more than 12% of patients.
Causes of menstrual disorders after abortion:
First, during the abortion, the mucous layer of the inner surface of the uterus (endometrium) is removed. At the same time, deeper layers are often damaged, which leads to the formation of adhesions and scars. Subsequently, the growth of the endometrium is uneven. Because of this, menstruation after an abortion becomes very scarce, or vice versa, abundant and painful. In contrast to surgical curettage, after medical abortion, menstruation is usually restored immediately, because mechanical damage to the endometrium does not occur.
Secondly, a strong hormonal failure leads to disruption of the ovaries. Dysfunction develops, which contributes to the occurrence of other complications. Here are some of them:
- uterine fibroids,
- endometriosis (ingrowth of the uterine mucosa into the muscle layer),
- pathological growth of the endometrium (hyperplasia),
- endometrial polyps,
- polycystic ovaries,
- adenomyosis (modification of endometrial tissue due to inflammation of the uterine glands), etc.
Serious hormonal disorders can lead to the formation of benign and malignant tumors.
- caused by hormonal disruption, include disorders of the thyroid gland and adrenal glands, abortion significantly increases the risk of breast cancer.
Directly affect the possibility of carrying a pregnancy after an abortion, can cause painful feelings during sex, as a result of reduced sexual desire, a woman less often has an orgasm.
Inflammatory diseases that often accompany abortions can negatively affect the blood supply to the fetus - its nutrition and breathing. The risk of fading of pregnancy, stillbirth, growth retardation, diseases of newborns increases. With severe complications, the likelihood of infertility is high.
occurs more often among women who have had an abortion, because adhesions formed in the fallopian tubes, greatly complicate their permeability.
The effect of abortion on subsequent pregnancies
Abortion definitely has a negative effect on reproductive function. Forced dilatation of the cervix during an abortion leads to its weakening, which can later cause miscarriage. The risk of miscarriage during a subsequent pregnancy after one abortion is 26%, after two abortions - 32%, and after three or more - increases to 41%.
Adhesions and damage to the uterus prevent the fetus from fixing in the uterus, its incorrect location, and perforation may provoke its rupture during labor.
- the impossibility of fertilization and carrying, may occur as a result of dysfunction of the genitals, when they are damaged or removed. According to doctors, up to 50% of all cases of female infertility are due to previously committed abortions.
Recovery and rehabilitation after abortion
Rehabilitation after abortion is designed to reduce the risk of subsequent complications. The duration of the recovery is influenced by the woman’s age, her state of health, the number of previous abortions and the presence of children (it is easier to abort healthy young women who have children).
Medical rehabilitation includes antibiotic therapy to prevent inflammation. Some time after the abortion, an ultrasound scan is necessary to rule out an incomplete abortion or other complications. A medical examination by an oncologist is necessary to exclude the appearance of tumors in the breast.
Often prescribed hormone therapy (for example, oral contraceptives), the drug must be selected by a gynecologist-endocrinologist, taking into account the hormonal background of the woman. Assign vitamins, regenerating drugs, a balanced diet. Physiotherapy and gynecological massage are widely used to treat gynecological diseases.
Another important component of recovery is psychological rehabilitation. Women may develop depression, guilt. Therefore, in many cases, the help of psychologists is recommended.
Sex and pregnancy after abortion
After an abortion, it is recommended to abstain from sex for at least 3 weeks. The fact is that after an abortion, the inner surface of the uterus is an extensive wound surface, very vulnerable to any infection. During sex immediately after an abortion, the likelihood of infection increases significantly, which can cause serious complications.
Another reason for limiting sex after an abortion is the high probability of a second pregnancy.
Unfortunately, no method of contraception currently provides a 100% guarantee, and until the frequency of the menstrual cycle has not been established, the probability of pregnancy after an abortion is great, even if you consider these days as "safe."
Pregnancy immediately after an abortion is very dangerous for an organism that has not yet had time to recover. In addition, a fertilized egg that adheres to fresh scar tissue will receive little nutrition.
It is recommended to plan a pregnancy after an abortion no earlier than in half a year. All this time it is necessary to use contraception during sex.
Prevention of complications
Compliance with a few simple rules can significantly reduce the risk of complications after artificial abortion.
- Banning sex in the first three weeks after an abortion,
- Controlling discharge after abortion and, if necessary, consulting with a doctor,
- Avoiding physical exertion during the first 2 weeks after surgery
- Timely emptying of the bladder and bowel,
- Compliance with the rules of hygiene (regularly hold the toilet of the external genital organs with boiled water or chamomile decoction, wear cotton underwear, during the first month after the abortion it is forbidden to take a bath, swim in the sea or pool, visit the sauna),
- Visit the gynecologist at least once every six months.
Possible complications after abortion and their causes
Abortion is usually done on terms from 5-6 weeks of pregnancy (mini-abortion) and up to 12 weeks. Abortion is a gross intervention in the natural physiological processes occurring in a woman’s body after fertilization, such as:
- hormonal changes,
- changes in the structure of the endometrium of the uterus in connection with the admission of the ovum,
- physical changes in the state of the ovaries and mammary glands.
In addition, during the operation there is a chance of accidental injury to various organs of the reproductive system, infection.
The consequences of such an intervention may be most unexpected. Often there are extensive inflammatory processes. Subsequently, diseases and hormonal disorders lead to pathologies such as ovarian dysfunction, cervical erosion, endometrial hyperplasia, benign and malignant tumors of the uterus and mammary glands. The result may be infertility or miscarriage subsequent pregnancies.
It is important to know how there are periods after an abortion, if the interruption has passed without complications, to which particular attention must be paid at this time. If there are deviations from the norm, it is necessary to be examined and treated.
What determines the onset of menstruation
After an abortion, the period of occurrence, the nature and amount of menstruation depends primarily on the method of abortion, the quality of the operation, as well as the state of the woman’s immune system, the nature of the menstrual cycle prior to the manipulation. The general state of reproductive health and the presence of endocrine diseases that cause hormonal disturbances in the body matter.
Establishing the reasons for the delay in menstruation after an abortion, the doctor also takes into account whether a woman has given birth or not, whether she has done abortions before, what her lifestyle is, the state of her nervous system, her age.
Apply 3 methods of abortion in the early stages:
- surgical (instrumental).
The least traumatic is the method of abortion with the use of special preparations for oral administration. The most dangerous is the surgical removal of the ovum. When choosing a method takes into account the duration of pregnancy.
After taking special medications, detachment of the ovum and its release to the outside occurs. Two types of drugs are taken:
- Stopping the production of progesterone, which suppresses the synthesis of estrogen, thereby maintaining the pregnancy.
- Causes uterine contraction to bring the embryo out.
It is considered normal if, in this case, a woman has discharge for 10 days with small amounts of blood. Monthly after abortion usually comes in time, the period of occurrence coincides with the expected. Sometimes they may be absent for 1-2 months, and then the cycle and nature of the monthly is restored.
Officially, medical abortion can be done no later than 42 days since the last menstruation. In later periods, the likelihood of incomplete removal of the egg increases, followed by surgical cleaning. It is usually done for a period of 3-4 weeks (the best option) and no later than 7 weeks.
Termination of pregnancy with the help of a device that creates low pressure inside the uterus, this is the so-called mini-abortion. A fetal egg is pulled out of the uterus under vacuum through a special catheter. This cleaning is carried out for a period of 5-6 weeks. If you do it earlier, then too small an egg may not enter the catheter, and for long periods there is a high risk of incomplete removal. Usually, the procedure lasts 15 minutes and is performed under local anesthesia.
For 10–15 days after cleansing, a woman may experience weak bleeding due to damage to small vessels in the uterus. Normal monthly after abortion come in about 30-35 days, it is possible a delay of up to 3 months. The duration and intensity of the discharge varies up or down. Often, periods become painful.
With this method of abortion, the uterus is scraped, the embryo itself, the surrounding epithelium, and even the underlying tissues are removed. At the site of the embryo remains a bleeding wound, the healing of which occurs within a few months. Full recovery of the menstrual cycle may be delayed for six months.
Most monthly after surgical abortion come in 28-35 days. Within 2 weeks after curettage (especially in the first 2-3 days), abundant dark red discharge of a heterogeneous structure with embryo remnants is observed. Until the full recovery of the body, the volume of the monthly fluctuates, menstrual pain occurs.
After 12 weeks, an abortion is not done, since there is a great danger that the embryo will not be removed, but only damaged. It is fraught with the birth of a child with physical deformities. With abortion for longer periods, the woman increases the risk of life-threatening uterine bleeding.
Causes of delayed menstruation after abortion
There are several reasons that after abortion menstruation does not occur in 3 months or longer. These include:
- Disruption of the natural hormonal balance. The longer the period at which the pregnancy is interrupted, the more likely the delay is. In some cases, periods are renewed only after treatment with hormones.
- Strong stress, depression. This increases the content of prolactin in the blood, which reduces the level of estrogen regulating the onset of menstruation.
- Damage to the epithelium of the uterus during curettage. When a large part of the endometrium is removed, infertility is possible, despite the fact that the ovaries are functioning normally. Endometrium is the basis of menstrual discharge, as well as the place of attachment of the embryo during pregnancy.
The onset of the next pregnancy cannot be ruled out, since ovulation after abortion in many women comes on time.
Types of abortion
You can get rid of pregnancy at the request of a woman only until the twelfth week.At a later date, this procedure is possible only for medical or social reasons: if the patient has a disease that is dangerous to her life or if a severe pathology is diagnosed in the fetus. Especially carefully it is necessary to approach the choice of the method of this manipulation to a woman who has not yet given birth. Assessing all the indications and risks, the doctor recommends the best possible method of abortion.
There are the following ways to perform abortion:
- mini-abortion - a way to remove the embryo from the uterus using a vacuum,
- surgical - removal of the ovum through curettage,
- farmabort - the use of drugs.
For late abortion, the drug is injected directly through a puncture of the fetal bladder, then the fetus is removed from the uterus.
Characteristics of abortion
The classic method (scraping) is carried out until the twelfth week of pregnancy. It is performed by medical surgical instruments in a clinic setting. The fertilized egg is separated mechanically from the wall of the reproductive organ. Before starting the procedure, the cervix is artificially expanded, through which the channel will be used to introduce instruments for manipulation and extract the fetal egg. The procedure is painful, therefore, is carried out with the use of analgesic drugs. Some time after the manipulation, the woman is under the supervision of a medical professional.
With a vacuum abortion, an apparatus is introduced into the uterine cavity, which creates a negative pressure in it. This helps to tear the fertilized egg from the place of its attachment. This procedure is performed until the fifth week from the moment of conception (no later than 20 days from the delay). After it, it is imperative to be examined by the attending physician, since it is not always possible to aspirate all the contents and there is a possibility that the pregnancy has survived. This manipulation is carried out only in the clinic.
Drug interruption is performed in the early stages (up to the fifth week). The effectiveness of this procedure is ninety-five cases out of a hundred: the shorter the period, the more successful the procedure. With this method, the drug is used, which increases the muscle tone of the mother's reproductive organ - has the effect opposite to that of progesterone.
After taking the drug, the process of expelling the fetus becomes irreversible, the woman can no longer change her mind to terminate the pregnancy.
Bleeding can begin after a few hours from the use of funds, more often - in one to two days. The fetus leaves the uterus with menstrual flow. At this time, the patient should be re-examined by the attending physician to ensure a positive result of the abortion. A woman can be at home all the time.
Causes of poor monthly during surgical abortion
After the termination of pregnancy for some time do not stop monthly. They have the appearance of an ordinary menstruation. This is due to the fact that the inner layer of cells, which grows monthly and separates, if pregnancy does not occur, exfoliated and leaves the uterus in a natural way. Vessels are damaged as a result of abortion and continue to bleed.
Scanty periods after curettage may be due to excessively thorough cleaning of the inner layer of the uterus in the process of mechanical removal of the embryo.
In addition, in the body of a pregnant there is a powerful restructuring, contributing to the bearing of the child. After an abortion, a woman's body experiences a hormonal failure. One of the manifestations of such dissonance are spotting.
With a poorly qualified medical professional, mechanical damage to the uterus can occur. In this case, blood may flow into the abdominal cavity or soak up the walls of the genital organ itself.
The uterine cervix, mechanically dilated, may close, and blood will not be able to come out, accumulating in the cavity. The danger of such a complication is that the blood is an excellent nutrient medium for various microorganisms, and against this background, the development of purulent inflammation is possible.
Causes of scanty discharge after pharmacist
The termination of pregnancy with peace is carried out in the early stages, when the endometrium has not yet had time to grow strongly, and the embryo is securely attached to the uterine wall. Scanty bleeding after peace can be the norm. However, it happens that the reason for such menstruation after a medical abortion is hidden in the following:
- significant hormonal changes, in which the menstrual cycle is restored only after a few months,
- mechanical obstruction of the outflow of blood through the vagina (tightly closed neck, blood clot above the exit into the vagina).
The latter reason is a serious threat to the life of a woman and the possibility of carrying the child in the future. An operation may be necessary to eliminate this complication. In addition, there is a possibility that the pregnancy is preserved.
Symptoms of poor monthly abortion
Poor menstruation after an abortion is manifested by the fact that the volume of blood released is significantly reduced, and only traces of it remain on the gasket. Over the entire period of menstruation, no more than 50 ml of blood can be released.
Spotting lasts from one to two days, but can last a month, standing out a few drops per day. The blood may be scarlet, fresh, but more often it has a brown color.
With mechanical damage to the uterine wall during surgery, the patient develops acute pain in the abdomen, aggravated by touching it. The stomach is swollen, there is constipation. The body temperature rises, thirst appears. The general condition of the patient worsens over time. In severe cases, the woman's mind becomes confused. If you do not consult a doctor in a timely manner, the patient may die.
Minor bleeding can be accompanied by violations of a woman’s general well-being: her mood worsens, irritability appears, bloating or pulling pain in the lower abdomen. The painful sensations of the whining character in the mammary glands are not excluded.
After a thorough survey and examination, the attending physician prescribes the following examinations:
- examination of the patient in the chair,
- determination of sex hormones in the blood and urine,
- examination of the contents of the vagina under a microscope,
- planting secretions on a nutrient medium to identify pathological microorganisms in the vagina,
- Ultrasound examination of the female genital organs to determine possible damage to the uterus,
- to determine the time of ovulation monitor the basal temperature.
Temperature is measured in the rectum. Use a mercury thermometer. Measurement is taken every morning before getting out of bed. Indicators woman writes in the schedule. A jump in temperature up indicates the onset of ovulation.
Any termination of pregnancy entails a danger to the woman’s body by the development of complications. Bleeding is minor. In each case, a consultation with the attending physician is needed in a few days. Hormonal restructuring of the patient’s body, which occurs after artificial extraction of the embryo, may further lead to disruption of the ovaries, the development of infertility, so it is important to carefully consider your decision.