Care for a woman undergoing an abortion

Care for a woman undergoing an abortion

Abortion is not only done for voluntary pregnancy, but also for taking parts of the fetus that remain inside after abortion, or for taking situations such as dead pregnancies or empty pregnancy. Ectopic pregnancy cannot be taken with an abortion, surgery or drug treatment is required. Abortion is a term used not only for pregnancy but also for materials taken from the uterus in non-pregnant patients. It can be abbreviated as D/C or D&C. These letters are abbreviations of Dilatation curettage. Dilation is used to expand the cervix.

Widening of the cervix is ​​necessary to insert the necessary tools (curette or aspirator, cannula) to curettage into the uterus. Metal spark plugs with increasing thickness in the form of thin rods are used for this expansion. Mostly, without the need for this expansion, a thin plastic cannula can be inserted through the cervix and an abortion procedure can be performed.

What is the abortion process? How is it done?

Usually, the appropriate time is between 5 and 7 weeks, and the process gets harder as the pregnancy progresses. Both general anesthesia and local anesthesia can be performed by numbing the cervix. However, before the abortion, every woman should be tested for blood count, blood group, and clotting. It should be evaluated especially in terms of blood incompatibility. If there is blood incompatibility, a protective needle should be made after the procedure. The presence of a genital infection should be investigated in the patient to be treated, and antibiotics should be given if necessary. Our suggestion is to perform the procedure in the hospital with an anesthesiologist.

For what purposes is abortion done?

1. Termination of Pregnancy (Medical Risk, Unwanted Pregnancy)

• It is made for the termination of unwanted pregnancies.
• Up to 10 weeks of pregnancy, abortion is performed according to the wish of the pregnant woman.
• If pregnant is single and single, self-approval is sufficient. If he is married, her husband also needs to approve.
• Abortion is not a birth control method.

2. Fractional Abortion In cases of very severe and prolonged bleeding, especially in women over 40 years of age, an abortion procedure is applied to identify the pathological cause and to choose the treatment that will stop bleeding.
3. Endometrial Dating To find out whether there is ovulation from infertility diagnosis, a small piece is taken from the uterus on the 21st day of the menstrual and the effect of the hormone progesterone into the uterus is investigated.

Medicines and control:

After the abortion procedure, the patient has usually prescribed antibiotics and pain medications to use. The patient is usually called for control 1 week after the procedure. In case of excessive bleeding and excessive pain, you should immediately contact your doctor without waiting for 1 week. It is normal for mild pain for 3-5 days and a small amount of bleeding for a maximum of 1 week. Sometimes bleeding can only last 1-2 days or there may be no bleeding, these are normal conditions.

On the day of the abortion, You can take a shower. You should not use tampons for bleeding after abortion, you should use pads.

After an abortion, you should immediately consult a doctor if:

•  High Temperature (over 38 degrees).
• Severe pain and cramps that do not go away with pain relief medications.
• If there is excessive bleeding after an abortion.
• If you have foul-smelling excessive discharge in the days after the abortion.
• If the bleeding does not decrease or increase despite 4-5 days after the abortion.

Fear of infertility exists in all women who experience unwanted pregnancy and who intend to end this pregnancy. If you need to have an abortion and experience such anxiety, remember that only a sloppy abortion will cause such a situation. Abortion, which is performed poorly in unsanitary conditions, leads to damage to the uterus, adhesions due to infection, and thus infertility.

It is a very, very low possibility of infertility to occur as a result of the abortion procedure performed by an expert and carefully vacuum curettage technique. Abortion, which is performed with sharp curettes by scraping method, without using one-time sterile instruments, damages the uterus, and may cause infertility. Our suggestion to our patients who make research to make an abortion decision is to carefully select the doctor they will have an abortion for and to question whether the environment where they will have an abortion is suitable for their health conditions.

Is There Any Menstrual Irregularity After Abortion? An abortion patient is usually expected to have menstruation from 30 to 40 days after the operation. Although menstruation is normally required during this period, menstruation may occur early in some cases, and this period may decrease up to 20 days, and in some cases, menstrual irregularity may occur after the abortion by delaying until the 50th or even 60th day. Since the menstruation day after the sixth week may indicate a complication after abortion, the patient should consult a specialist physician without losing time.

Are there any risks of abortion?

While even the smallest surgical intervention has risks, the abortion procedure has the same risks as any surgical operation, but these risks have been greatly reduced with the rise of medical standards and the introduction of the mixed vacuum method.

Infection

Another complication is infection. It usually occurs 5-6 days after the procedure. If the developing infection spreads to the tubes, it may cause adhesion and congestion in the tubes, resulting in infertility. The risk is reduced if the hygiene and sterility rules are followed during the procedure. Sometimes an infection may occur as a result of the factors caused by the person. It is ideal to apply antibiotic therapy for preventive purposes after every abortion procedure.

To prevent infection after abortion, preventive antibiotic therapy should be recommended especially for patients who have vaginal infections or have a bad odor from their vagina during the abortion. If an infection is not treated, diseases that cover the entire reproductive organs (tubes, uterus, ovaries, pelvic peritoneum) that we call pelvic inflammatory disease can occur. Since there will be adhesions in the uterus in the future (Asherman syndrome) in such a disease, adverse conditions such as infertility (infertility) problem or ectopic pregnancy may occur.

What Should Be Done After The Curettage?

If the abortion procedure was applied under general anesthesia, there may be a feeling of dizziness on the first days of an abortion. These days, fatigue, malaise, and groin pain are normal. Mild, spotting-style bleeding may occur for 10 days after the abortion. This bleeding is normal. Bleeding can begin a few days after an abortion. However, if the bleeding is very intense and severe, if the pain and pain increase with bleeding, it is necessary to consult a specialist without losing time.

One hour after the abortion procedure applied with general anesthesia, the meal can be eaten. However, it is recommended that the first meal be light and non-fat. Soup or breakfast foods can be consumed. Drugs prescribed by the doctor after an abortion should be used. In this way, the risk of infection will be minimized. Sexual intercourse is prohibited until the recovery period is completed.

Excessive Bleeding

Especially in large pregnancies, excessive bleeding may occur during the procedure. If the bleeding cannot be stopped, the patient can have a shock hemorrhagic. It is a fairly rare condition.

Bleeding: In every 1000 abortions, excessive bleeding occurs during the procedure. If abortion has been completed, if no pregnancy material remains, bleeding will stop after abortion, it is normal for the bleeding to continue for a little longer. To ensure this condition, after the abortion, after the procedure is completed, the uterine cavity should be checked by ultrasonography, and it should be ensured that no pregnancy material remains in the uterus.

However, if the patient has special conditions (blood-thinning treatment, blood thinning vitamins, bleeding coagulation disorder, hematological disorders that increase bleeding, etc.), bleeding is not stopped even after the abortion, even if the inside of the uterus is very clean. In this case, the most appropriate anti-bleeding treatment should be determined according to the characteristics of the patient.

Surgery may even be required to be taken surgically, especially in large pregnancies or in cases of dead pregnancy such as placenta and membranes adhering, and mole pregnancy. Before the abortion, a detailed anamnesis should be taken, the patient’s illnesses, medications, etc. should be learned and the risks that may occur after the abortion should be stated, these issues should also be documented in abortion confirmation form and signed approval of the patient should be obtained.