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Carrying out termination of pregnancy for medical reasons. Late term abortion for medical reasons Late term for medical reasons

Termination of pregnancy at later only possible in exceptional cases. The woman’s desire is not an indication for surgical intervention. Doctors are afraid of the possible negative consequences of late abortion, the main one of which is secondary infertility.

Do they have late-term abortions?

At the request of the woman, termination of gestation can be carried out at the initial stages of fetal development. The latest date for termination of pregnancy initiated by the mother is 12 weeks. Abortion after this time is called late and is carried out only in exceptional cases. The choice of method by which the pregnancy process is terminated is made based on the current period, the age of the pregnant woman and her state of health. So, after 20 weeks of gestation, doctors do not use classical abortive techniques, but perform artificial birth.

Indications for termination of pregnancy

The decision that there is a need for late-term abortion is made by a medical commission. The doctors included in it (obstetrician-gynecologist, specialist in the field that causes the need for abortion (sociologist, representatives of government agencies)) take into account the results of the medical examination, the social conditions in which the pregnant woman lives. The final decision on the need to terminate gestation at a later date can be made on the basis of:

  • medical indications;
  • social indications.

Medical indications for termination of pregnancy

This type of indication for late pregnancy termination is taken into account initially. In most cases, they are associated with the presence of diseases in a pregnant woman that can prevent her from carrying and giving birth to a baby normally. In addition, late-term abortion may be indicated if defects and developmental disorders are detected in the fetus, which after birth will cause disability or death of the baby. Among the main medical indications for termination of pregnancy after 12 weeks are:

  • mental and somatic diseases of a pregnant woman;
  • the presence of chromosomal pathologies in the fetus that are incompatible with life;
  • severe illnesses of the pregnant woman (hematitis, viral infections, tuberculosis);
  • the possibility of a woman’s death with further progression and development of pregnancy.

Social indications for abortion

Social reasons for late pregnancy termination are due to the presence of factors that can worsen the living conditions of the pregnant woman herself or the unborn baby. Doctors often take into account those social factors that arose directly during pregnancy itself:

  • death of a spouse;
  • divorce;
  • arrest of one of the child's parents.

In addition, there are a number of social factors that can also be taken into account when making a decision about abortion, but their presence is not a strict indication for termination of gestation:

  • lack of housing;
  • presence of more than 3 children in the family;
  • The age of the expectant mother is less than 18 years.

How is a late-term abortion performed?

Methods for terminating pregnancy in later stages are practically no different from those used by doctors in the early stages of gestation. However, late pregnancy termination is not carried out using pills. The choice of technique is made by a medical commission based on the results of the examination, taking into account the duration of pregnancy and the characteristics of its course. Each method has its own characteristics and a specific technique. Among the methods used to terminate pregnancy, after 12 weeks the following are used:

  1. Intraamnial administration of fluids.
  2. Forced dilatation of the cervix.
  3. Minor caesarean section.

Method of intraamnial fluid administration

Abortion in late pregnancy using hypertonic solutions is a common technique. The mechanism of action of this method of interrupting gestation is associated with a change in the volume of amniotic fluid and its osmotic pressure. As a result of such changes, stretching of the muscular structures of the uterus occurs, followed by their contraction.

In this case, doctors associate the increase in uterine tone with the possible toxic effects of substances that begin to be released after the death of the fetus (as a result of exposure to a hypertonic solution). Strong contractile movements of the myometrium lead to the expulsion of the fetus outward, resulting in a complete termination of the pregnancy. In its mechanism, the method resembles medical abortion, which is not used in later stages. After the procedure, doctors carefully examine the uterine cavity to exclude the presence of fetal tissue remains.


Dilatation and evacuation

Late pregnancy termination for medical reasons is often carried out using the dilatation and evacuation method. The optimal period for performing an abortion using this method is 15–18 weeks. First, the doctor performs an artificial dilation of the cervical canal, using surgical instruments with a gradual increase in the dilator (dilatation).

After gaining access to the uterine cavity, doctors dissect the fetus and scrape out the membranes. At the end of this stage, they begin evacuation - removing the remains of the fetus outside using vacuum suction. Evacuation with pre-dilation is recognized as a gentle method of terminating pregnancy in late stages and is recommended by WHO as an alternative method of abortion.

Minor caesarean section

In the later stages, this type is practically no different from the usual cesarean section. Access to the fetus is through an incision on the anterior abdominal wall, through which the fetus is subsequently removed. The operation is performed under general anesthesia. This method is rarely used, in cases where there are contraindications to the method described above. During the operation, there is a high risk of developing uncontrolled bleeding, so the decision to perform it is made when there is a threat to the life of the woman herself.

Artificial birth method

When the need arises to terminate a pregnancy in the later stages, after pregnancy, doctors change the tactics of artificial childbirth. In this case, the fetus is not removed from the uterine cavity, but procedures are carried out that cause it to be expelled independently. When talking about how late pregnancy termination occurs, doctors often use the term “stimulation of premature birth.”

At a late stage, abortion is not called termination of pregnancy from a psychological point of view: by this time the fetus can already be called a child, and the expectant mother already has an attachment to the baby. The hormones synthesized in it form the feeling of motherhood. Artificial childbirth begins with stimulation - prostaglandins are introduced into the woman’s body, which increase the tone of the uterine muscles and cause its contractions. As a result, labor begins.


Discharge after late pregnancy termination

Abortion is always a factor that weakens the body’s immunity, so it is important to monitor the woman’s well-being. A favorable environment for the development of infection and inflammation is created in the reproductive system. Discharge after an abortion is assessed as an indicator of the state of the reproductive system. Normally, they appear on the 2-3rd day after the procedure; they may have small amounts of blood, but they do not smell. A change in these parameters may indicate an infection. Yellow discharge with a rotten smell should be a reason to consult a doctor.

Brown discharge that appears after a late pregnancy termination can last up to 10 days. In some cases, women may notice the appearance of blood clots (clotting occurs under the influence of body temperature). The volume of such discharge is moderate, and they themselves are not accompanied by pain in the lower abdomen or in the vaginal area. A change in discharge to dark brown may indicate polyps in the uterus.

Recovery after late pregnancy loss

The duration of the recovery period is determined by the method of termination of pregnancy and the period at which it was performed. Late-term abortions are highly painful and stressful for the body. To exclude possible early complications, the woman is under the supervision of a specialized doctor in a hospital setting. In general, recovery after an abortion involves:

  1. Preventing blood loss.
  2. Eliminating the possibility of infection (antibiotic therapy, anti-inflammatory drugs).
  3. Instrumental examination of the woman’s reproductive system to exclude residual membranes.

Consequences of late pregnancy termination

Inquiring from doctors about the possible consequences, women are trying to find out whether it is possible to have an abortion and why this procedure is dangerous. Gynecologists say that this procedure is extremely undesirable - complications and consequences of an abortion may appear several months and years later. Considering the time of their development, doctors subdivide possible complications on the:

  1. Early– occur during the termination procedure (uterine perforation, bleeding).
  2. Deferred– develop within a month after surgery (endometritis, hematometra, progression of pregnancy).
  3. Remote– appear a year later or later (scar changes in the internal os, cervix, damage to the endometrium, obstruction of the fallopian tubes).

Late pregnancy termination can only be carried out if there are compelling reasons. Late termination means abortion in the second and third trimesters.

What do you need to know?

According to the law, termination of pregnancy on the initiative of the woman herself is possible strictly up to 12 weeks, that is, at early stages. Thus, 3 months is the latest date for termination of pregnancy.

The earlier an abortion is performed, the fewer negative consequences for the woman’s body and the development of any complications.

Termination of pregnancy after 12 weeks refers to late-term termination. 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, cessation of gestation is done before 6 months, for medical reasons - at any month. The decision whether to have an abortion or not in the long term is always up to the woman. But the doctor must convey to the pregnant woman all the information about why an abortion is required and what its possible consequences are.

Dilatation and curettage of the uterus

A method used to terminate 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 curettage of the uterine cavity in order to extract the fetus.

The operation has a high risk of injury and perforation of the uterine walls.

Artificial birth

Induction of artificial labor is used at 25-32 weeks. Drugs are introduced into the body that cause the uterus to contract.

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

A method of extracting the fetus by making an incision in the wall of the uterus through the abdominal cavity. It is carried out until 24 weeks of pregnancy, after which it is a caesarean section.

It is often performed when it is impossible to extract the fetus by other means.

In the video about methods of abortion:

Possible consequences

Late operation has a serious negative impact on the woman’s body, since it has already undergone hormonal changes aimed at pregnancy and childbirth.

Possible complications after late-term abortion:

  • injury to the uterus;
  • an infectious process resulting from embryonic remains in the uterine cavity;
  • purulent complications;
  • uterine bleeding;
  • – growth of the endometrium outside the uterine cavity;
  • endometritis - inflammation of endometrioid tissue in the uterus;
  • menstrual irregularities;
  • disruption of ovarian function due to hormonal imbalance.

Subsequently it is possible:

  • secondary infertility;
  • the appearance of adhesions in the pelvic organs;
  • genitourinary infections.

Rehabilitation period

Long-term abortion is extremely stressful for a woman, both in terms of physical health and psychological health.

For a speedy recovery of the body, the doctor gives recommendations:

  • refusal of sexual activity for a month after surgery;
  • lack of physical activity;
  • refusal to use sanitary tampons;
  • taking vitamin and mineral complexes;
  • protein diet;
  • monitoring temperature, pulse rate and blood pressure levels;
  • control of vaginal discharge.

In addition, after the intervention, the woman is prescribed a number of medications - antibacterial and hormonal, which must be taken strictly according to the prescribed regimen.

Termination of pregnancy in late stages is unacceptable only at the request of the woman. To do 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.

IN modern world There are many means of protection against unwanted pregnancy, but there are circumstances in a woman’s life when termination of pregnancy is required. This situation becomes more complicated when the pregnancy is already long. For medical reasons, termination in late stages of pregnancy is permitted in case of pathology of fetal development, maternal illness, intrauterine fetal death and some other reasons associated with a threat to the patient’s health.

Late pregnancy termination for medical reasons

Late-term pregnancy termination for medical reasons is most often performed between 12 weeks and 22 weeks. Medical termination of pregnancy during these periods is considered dangerous to the health of the mother, so it is resorted to as a last resort. Also, termination at longer stages of pregnancy is allowed for women for social reasons - in the event of the death of the husband; lack of funds for maintenance; if the pregnant woman is a minor; some other reasons. IN in this case permission to have an abortion is issued after consideration by the commission. It consists of a doctor, a social worker, a lawyer and other representatives.

Termination of pregnancy in later stages for medical reasons is permitted when there is a threat to the health and life of the mother: serious illness; injury incompatible with pregnancy; upcoming surgery; if medical procedures are carried out that can cause irreparable harm to the fetus; under conditions of fetal death; for disturbances in fetal development.

Late pregnancy termination for medical reasons is possible only in a hospital setting. A sterile tube with a rod is used and inserted into the cervix. Then the rod is removed and a needle is inserted, a puncture is made in the amniotic sac and amniotic fluid is collected. For the procedure of late pregnancy termination for medical reasons, a special saline solution is injected into the amniotic sac using a needle. The death of the fetus is painful, it already feels pain. While in the solution, the fetus receives burns throughout the body and dies in agony from a cerebral hemorrhage.

This method of termination of pregnancy is possible for a period of no more than 15 weeks. Complications after such a procedure may be headache, severe chest pain, development of hypotension, shock, coma and even death. Late pregnancy termination for medical reasons with curettage of the uterine cavity is considered a very high-risk operation. The risk increases at 15 weeks of pregnancy.

As a method of terminating pregnancy in later stages for medical reasons, opening the amniotic sac is used. If the administration of an isotonic solution is contraindicated for a woman, then this method is used. Using a dilator, the cervix is ​​opened, then the amniotic sac is opened and the presenting part of the fetus is grasped with forceps. A weight is attached to the forceps and agents are prescribed that enhance uterine contraction. Such an abortion can take a long time. Complications include infection of the uterus and cervical rupture. This method is used from 17 to 28 weeks of pregnancy, if there are contraindications to other methods.

Termination of pregnancy in later stages for medical reasons is also carried out using minor surgery. caesarean section. The fetus is most often alive; its access to the lungs is cut off. A complication in a woman after such an operation may be thromboembolism. This method is used only in cases of emergency abortion, when other methods are contraindicated, as it is dangerous for serious complications.

Transvaginal caesarean section is another method of terminating a late pregnancy for medical reasons. This method is almost never used, as it often causes complications and the operation itself is technically complex.

Termination of pregnancy in late stages using folk remedies

Late pregnancy termination using folk remedies may not be successful and may cause severe bleeding, large blood loss and the death of the woman. Failure when a woman tries to get rid of pregnancy with the help of folk remedies will lead to the birth of a weakened baby with developmental pathologies or to an abortion with complications, psychological trauma, and the development of infertility.

Pills for late pregnancy termination

One of the gentle methods of miscarriage is with the help of various medications. Abortion pills are not used in later stages. The maximum period for a medical abortion is 6 weeks. But even if you take the pills within these periods, there is no guarantee that they will help you. In the later stages of pregnancy, only more radical methods of termination of pregnancy that are dangerous with complications are possible.

Seeking an abortion should be a last resort when there is no other solution. Take responsibility for your health and your new life, use contraception, and an unwanted pregnancy will not appear in your life.

Every woman has a choice whether to give birth to a child or terminate the pregnancy. But, such a decision must be made before 12 weeks. During this period, abortion is the least risky for women's health. It is true that it is possible to terminate a pregnancy at a later stage for medical reasons. Such an operation is necessary to save the health and life of the mother or if the fetus is not viable.

Reasons for late termination

Every expectant mother must undergo regular examinations and tests. This allows doctors to monitor the development of the fetus and the health status of the pregnant woman. One of the most important techniques is ultrasonography, which allows us to determine the degree of development of the child’s systems and organs.

An ultrasound, which is performed between 12 and 14 weeks, can show that the fetus has anomalies and defects that will prevent the child from developing properly. In such cases to the expectant mother An MRI is prescribed to clarify the diagnosis. If the presence of abnormalities is confirmed, the woman is advised to terminate the pregnancy. Parents have the right to decide whether to keep a non-viable or sick child.

Sometimes carrying a child poses a threat to a woman’s health and life. In this case, late pregnancy termination is also performed. There are other reasons for carrying out such operations:

  • Death of the child's father.
  • Spouse's disability.
  • Serious illness of the first child.
  • Conception that is the result of rape.
  • Imprisonment of a pregnant woman.
  • Deprivation of a woman's parental rights to existing children.
In this case, the pregnancy is terminated at a late stage for social reasons.

Methods for performing late-term abortion for medical reasons

Late pregnancy termination is carried out for medical reasons in two stages. First, prostaglandins are introduced, which soften and make the walls of the cervix more elastic. After this, labor is induced. Considering that a long-term abortion may result in a live baby being born, feticide of the fetus is performed before the operation. This kills the fetus.

The procedure is performed using an ultrasound machine. In this case, potassium chloride is injected into the fetal heart. To do this, an injection is performed through the abdominal wall. As a result, during artificial birth a lifeless body appears.

Experts believe that it is safer to have a late-term abortion through dilation. This is the dismemberment of the fetus in the uterus and its removal in parts. Such operations are performed in the second trimester, when the body is not yet ready for childbirth.

If such an abortion is performed for medical reasons, local paracervical or epidural anesthesia is used. Medications The tissue of the cervix is ​​softened, dilators and a curette are installed, and the uterine cavity is cleaned with a vacuum.

Rivanol can be used in late-term abortions. Previously in medicine, this drug was used to resolve hematomas. This medication with a high alcohol content is injected into the amniotic fluid. As a result, the child dies and premature birth begins. At the same time, the woman feels pushing and contractions, as during natural childbirth.

If it is necessary to abort a large fetus, a caesarean section is performed. This method is used only when the child has no muscle contractions, breathing, pulsation of the umbilical cord, or heartbeat, that is, a frozen pregnancy is observed.

Consequences of late termination of pregnancy

Every woman should be aware that late pregnancy termination is fraught with serious consequences. In addition to the fact that as a result of such an operation it is necessary to kill a child, which is contrary to the rules of morality, mental and physiological complications for health may also arise.

May be observed stressful state, after premature birth, bleeding often occurs. If you need to have a late-term abortion, you should prepare for the fact that this procedure is painful.

Sometimes women who contact medical institutions to terminate a pregnancy are refused because there are no medical or social indications for a late abortion. They find specialists on the Internet or use information from friends to carry out an underground operation.

It should be understood that performing surgery at home at a later date can not only lead to serious complications, but also death. Therefore, this method of getting rid of a child cannot be used.

If for some reason it was not possible to terminate a pregnancy in the early stages and there is a real need for a late termination of pregnancy, you need to know about the types of termination of pregnancy, the timing and conditions of termination of pregnancy, what is required in order to terminate a pregnancy in the late stages timing and how this threatens the female body.

Undoubtedly, there are few people who would have a positive attitude towards abortion, but be that as it may, abortion is a way to end an unwanted pregnancy, a kind of family planning method. Although, of course, it is better to prevent pregnancy if the family is not yet ready for responsibility.

It is also undeniable that abortion is comparable to murder. Many people believe that abortion is the murder of an unborn child. In addition, this intervention in a woman’s body brings her enormous stress, both on a physiological and psychological level. But it is worth noting that not all women come to the decision to terminate a pregnancy in the later stages due to their unpreparedness to become a mother.

For some, this is due to the inability to bear a child. There are a number of women who have to terminate their pregnancy due to serious problems with health. Everyone has different reasons. But if it turns out that you need to terminate a pregnancy in the later stages, then you should learn about the types of termination of pregnancy.

Types of pregnancy termination

There are three types of termination of pregnancy:

  1. Spontaneous abortion. Its essence consists in the non-mechanical rejection of the fetus from the wall of the uterus before the embryo’s body becomes able to function independently. In this case, doctors do not name specific reasons for “miscarriage,” since this may be influenced by the following factors: bad habits, complex diseases, previous abortions, and heavy lifting by the pregnant woman.
  2. Induced abortion. This procedure is presented in the form of a vacuum (mini) abortion, the essence of which is that everything is carried out using vacuum suction, when the fertilized egg is removed from the uterus after a period of up to 20 days of delay.
  3. Medical abortion. This procedure is carried out without surgery, by exposing the uterus to chemicals that lead to rejection of the fetus. This operation is carried out for a period of up to 60 days of delay.

Medical is performed in the second trimester. It is similar to a mini-abortion, only the embryo is scraped out rather than sucked in. The fetus itself is divided into parts and removed from the uterus. This type of abortion poses some danger to female body. After all, there is a high probability that mechanical damage to the walls of the uterus will occur.

Please note that this may cause serious health problems, including death, in the future. In conclusion, I would like to dwell in more detail on abortions performed in late stages of pregnancy: surgical, saline filling and artificially induced labor.

But first we need to talk about the terms and conditions of termination of pregnancy. We also recommend that you read articles on the topic: “How to terminate a pregnancy in the early stages?” and “How to terminate an early pregnancy at home?”

Terms and conditions for termination of pregnancy

If a woman is more than 12 weeks pregnant, then her mere desire to have an abortion is impossible. Because late abortion is done if there are medical or social indications. That is, the health of the mother and fetus is taken into account. And only medical advice or a court can decide on the need to terminate a pregnancy at a later stage. The reasons for this may vary.

This is a severe form of the disease in the mother, and the fact of rape, and the pathology of the fetus, and the social failure of the woman and much more. But each of the reasons is taken very seriously. But whatever the reason why a woman undergoes an abortion in the later stages, in any case it is dangerous for the vital functions of the body. That is why it is better to use contraceptives initially and then you will not have to cross the line.

Between 13 and 22 weeks of pregnancy, pregnancy is terminated artificially. The latest date for an abortion is considered to be a woman's 28th week of pregnancy. Everything else falls into the category of artificial birth, when the child is killed in the womb, that is, the fact of birth is there, but the child will not be born.

If there are compelling reasons for an abortion, the following should be done:

  • contact a gynecologist to obtain information about the duration of pregnancy and health status;
  • undergo an ultrasound examination;
  • donate blood for hormonal analysis.

Before starting the procedure, the doctor must not only advise the patient regarding abortion methods, but also warn about possible consequences. It is also very important for a woman to receive competent psychological assistance and support.

Late term abortion

  1. We propose to consider the currently ineffective method of saline abortion or saline filling. Its essence is that a needle is inserted intravaginally into the sac with amniotic fluid where the fetus is located. Then a certain amount of amniotic fluid is pumped out, replacing it with a caustic saline solution, which gradually kills the embryo. This is an extremely cruel way of depriving a fetus of life, since first the embryo receives a chemical burn, and then there is an outpouring of blood into the brain. And during all this time, the embryo beats in spasms and convulsions. This brings additional psychological trauma to the mother. The torment of an unborn child can last from 24-48 hours, then the muscles of the uterus become toned, thereby rejecting the dead fetus, which, after the manipulations, looks as if it had been scalded with boiling water. As for the skin color, it has a bright burgundy-lilac color. After this type of abortion, a woman has a very high risk of complications, as well as after any type of late pregnancy termination.
  2. In cases where a woman cannot undergo saline abortion for health reasons, she is induced to give birth prematurely using special medications. The uterus contracts, resulting in a “miscarriage.” The mother experiences similar sensations as during normal childbirth. The only difference is that contractions are stimulated artificially.
  3. There is also another method of terminating a pregnancy in later stages, that is, a “small” caesarean section. There are practically no differences in this operation from the standard caesarean section procedure. An incision is made to the woman, removing the baby from the uterine cavity, after which the air to respiratory tract(asphyxia) and the child dies. This method affects a woman’s subsequent fertility. But sometimes this is the only chance to save her life.

Consequences of late abortion

Termination of pregnancy affects every woman differently and has its consequences. This is due to the psychological and physiological characteristics of the body. For one person, this may go perfectly, a competent doctor worked, and all pre-operative and post-operative conditions were met, but the woman will have complications. The other one has women's health this may not have an effect. But with late termination of pregnancy this happens extremely rarely.

Bleeding is the most unfavorable outcome of an abortion. After an abortion, the uterus does not lose tone and the blood vessels are not blocked. With large blood loss, death is possible. To avoid infectious and inflammatory diseases after surgery, you should carefully observe genital hygiene.

Once again I would like to note that family planning plays a very important role. And if you are not ready for motherhood, try to prevent pregnancy. Find out what to do to avoid getting pregnant. Then you won’t have to wonder about how to terminate a late pregnancy.